Individual
LISA ORF MIKECIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1032 CROSSWINDS CT, WENTZVILLE, MO 63385
(888) 403-1071
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2006029894
MO
Other
Enumeration date
01/11/2007
Last updated
02/27/2019
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