Individual
MS. MICKEY MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
242 W SHAMROCK AVE., PINEVILLE, LA 71360
(318) 484-6255
(318) 484-6298
Mailing address
PO BOX 5031, PINEVILLE, LA 71361-5031
(318) 484-6255
(318) 484-6298
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2209
LA
Other
Enumeration date
01/19/2007
Last updated
08/08/2008
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