Individual
DR. RACHEL LYNN MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2410 GRAPE RD, STE 1, MISHAWAKA, IN 46545-3015
(574) 243-9370
Mailing address
2410 GRAPE RD, STE 1, MISHAWAKA, IN 46545-3015
(574) 243-9370
(574) 243-9375
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042493A
IN
Other
Enumeration date
03/03/2011
Last updated
06/27/2020
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