Individual
CRYSTAL JOY MICKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CRC
Contact information
Practice address
961 HALL ST, BAINBRIDGE, GA 39819-4645
(229) 726-4714
Mailing address
961 HALL ST, BAINBRIDGE, GA 39819-4645
(229) 726-4714
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
10/22/2018
Last updated
06/17/2019
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