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Individual

DR. MIKELL RYANNE EHNLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
3716 W BRIGHTON AVE, PEORIA, IL 61615-2938
(309) 692-7755
Mailing address
2300 S MAIN ST, APT C, EUREKA, IL 61530-1633
(847) 848-0203

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071.008074
IL

Other

Enumeration date
03/28/2011
Last updated
09/24/2018
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