Individual
COLETTE MICKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
(815) 756-4875
Mailing address
12 HEALTH SERVICES DR, DEKALB, IL 60115-9637
(815) 756-4875
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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