Individual
MICHAEL CHARRON MICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HEALTH COACH
Contact information
Practice address
8708 BIG TREE CIR APT G, LOUISVILLE, KY 40220-5856
(269) 815-2077
Mailing address
8708 BIG TREE CIR APT G, LOUISVILLE, KY 40220-5856
(269) 815-2077
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
NA
NC
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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