Individual
SUZANNE ELLIS MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
114 HIGHLAND AVE, FAYETTEVILLE, NC 28305-5306
(910) 484-0176
(910) 484-5781
Mailing address
114 HIGHLAND AVE, FAYETTEVILLE, NC 28305-5306
(910) 484-0176
(910) 484-5781
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
904
NC
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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