Individual
ASHLEE MICKELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCW
Contact information
Practice address
610 S 5TH ST, LARAMIE, WY 82070-3720
(307) 272-3515
(307) 272-3515
Mailing address
PO BOX 1704, LARAMIE, WY 82073-1704
(307) 745-8997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PCSW-458
WY
1041C0700X
Clinical Social Worker
Primary
458
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
458
STATE
WY
Enumeration date
09/30/2011
Last updated
11/17/2022
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