Individual
SUSAN MICKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
4052 OLEATHA AVE, SAINT LOUIS, MO 63116-3606
(314) 452-9291
Mailing address
4052 OLEATHA AVE, SAINT LOUIS, MO 63116-3606
(314) 452-9291
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
13100027
MO
Other
Enumeration date
11/25/2013
Last updated
11/25/2013
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