Individual
MRS. KATELYN MICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
201 6TH ST, A, NEWPORT BEACH, CA 92661-1193
(713) 249-1468
Mailing address
201 6TH ST, A, NEWPORT BEACH, CA 92661-1193
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
14767
CA
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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