Individual
MRS. MIKAYLA A ALEXIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MIRACLE LN, GARDEN VALLEY, ID 83622
(208) 462-0077
Mailing address
25 MIRACLE LN, GARDEN VALLEY, ID 83622
(208) 462-0077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/13/2022
Last updated
09/22/2023
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