Individual
KRISTIN LYNN MICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
500 N MAITLAND AVE, SUITE 110, MAITLAND, FL 32751-4482
(407) 628-5354
(407) 628-0254
Mailing address
500 N MAITLAND AVE, SUITE 110, MAITLAND, FL 32751-4482
(407) 628-5354
(407) 628-0254
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9141
FL
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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