Individual
RAQUEL ANN MICKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 522-9474
(928) 522-9475
Mailing address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 522-9474
(928) 522-9475
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-16678
AZ
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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