Individual
MICKELL DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 W HOPKINS ST, MILWAUKEE, WI 53206-1749
(414) 218-1001
Mailing address
PO BOX 91352, MILWAUKEE, WI 53209-8352
(414) 628-0112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5216-226
WI
101YM0800X
Mental Health Counselor
Primary
5216-226
WI
101YP2500X
Professional Counselor
5216-226
WI
106H00000X
Marriage & Family Therapist
5216-226
WI
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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