Individual
MICKALA S WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
725 CLINTON PKWY, CLINTON, MS 39056-5245
(601) 707-8666
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7271
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-4690
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S-4690
—
MS
Enumeration date
03/09/2022
Last updated
06/09/2026
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