Individual
TYKEYANA MICKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2537 GERVAIS ST, COLUMBIA, SC 29204-2375
(803) 784-8460
Mailing address
2537 GERVAIS ST, COLUMBIA, SC 29204-2375
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8581
SC
Other
Enumeration date
01/20/2021
Last updated
06/06/2023
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