Individual
MR. SOREN B MICKELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-1000
Mailing address
2108 E THOMAS RD, PHOENIX, AZ 85016-7761
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11576
AZ
Other
Enumeration date
07/13/2020
Last updated
04/15/2025
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