Individual
MISS MICHELE MARIE MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, BACS
Contact information
Practice address
2244 11TH ST, MANDEVILLE, LA 70471-1824
(225) 266-8122
(504) 617-7983
Mailing address
2244 11TH ST, MANDEVILLE, LA 70471-1824
(225) 266-8122
(504) 617-7983
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8769
LA
Other
Enumeration date
08/30/2006
Last updated
11/21/2014
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