Individual
MYKAL MANSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9401 W THUNDERBIRD RD STE 188, PEORIA, AZ 85381-4210
(623) 263-3972
Mailing address
PO BOX 748465, ATLANTA, GA 30374-8465
(855) 284-7483
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A17194
NC
101YP2500X
Professional Counselor
Primary
23889
AZ
Other
Enumeration date
01/06/2022
Last updated
04/20/2026
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