Individual
MS. MELINDA RAQUEL MICKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ORT/L
Contact information
Practice address
304 LANCASSANGE DR, JEFFERSONVILLE, IN 47130-5454
(502) 645-0564
Mailing address
304 LANCASSANGE DR, JEFFERSONVILLE, IN 47130-5454
(502) 645-0564
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31004140A
IN
225X00000X
Occupational Therapist
Primary
KY-R1598
KY
Other
Enumeration date
08/22/2008
Last updated
08/22/2008
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