Individual
JOANNA MIKULSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2814 GRAY FOX RD, MONROE, NC 28110-8422
(704) 821-0568
(704) 821-0570
Mailing address
2814 GRAY FOX RD, MONROE, NC 28110-8422
(704) 821-0568
(704) 821-0570
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801024484
—
NC
05
—
7413379
—
NC
Enumeration date
06/23/2009
Last updated
04/01/2019
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