Individual
AMBER MICOLICHEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
823 ELMORE ST, GREEN BAY, WI 54303-3571
(920) 265-0457
Mailing address
823 ELMORE ST, GREEN BAY, WI 54303-3571
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
219-49
WI
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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