Organization
RAQUEL MICKELSON LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL MICKELSON LPC (OWNER/COUNSELOR)
(928) 225-5429
Entity
Organization
Contact information
Practice address
510 E CHERRY AVE, FLAGSTAFF, AZ 86001-4711
(928) 225-5429
Mailing address
PO BOX 1703, FLAGSTAFF, AZ 86002-1703
(928) 225-5429
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669007043
—
AZ
Enumeration date
08/08/2022
Last updated
08/08/2022
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