Individual
JESSICA ELAINE MIKOLAICHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-HIS
Contact information
Practice address
195 STOCK ST, SUITE 112, HANOVER, PA 17331-2266
(717) 698-1541
(717) 698-1430
Mailing address
195 STOCK ST, SUITE 112, HANOVER, PA 17331-2266
(717) 698-1541
(717) 698-1430
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
F03277
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F03277
STATE LICENSE
PA
Enumeration date
06/04/2014
Last updated
03/07/2016
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