Individual
CARLY MIKKILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-IT
Contact information
Practice address
S73W16485 JANESVILLE RD # 202, MUSKEGO, WI 53150-8960
(920) 395-9857
Mailing address
6808 UNIVERSITY AVE STE 108, MIDDLETON, WI 53562-2779
(847) 331-0463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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