Individual
CHEYENNE RENE MIELKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
723 WALNUT ST, MOUND CITY, KS 66056-5256
(913) 416-2244
Mailing address
6214 24TH AVE, BROOKLYN, NY 11204-3319
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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