Individual
DONALD SCOTT MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
200 BEATTY ST, MEDFORD, OR 97501-5811
(541) 774-4812
(541) 774-7979
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/10/2015
Last updated
10/23/2019
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