Individual
SHAWNA MIKESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-0184
Mailing address
452 W MARKET ST, XENIA, OH 45385-2815
(937) 376-8700
(937) 376-0184
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C0500348TRNE
OH
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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