Individual
DE'VONCIA LACHEL MICKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 E OLD US 74/76, LAKE WACCAMAW, NC 28450-1927
(252) 521-0773
Mailing address
855 OLD HOMESTEAD RD, KINSTON, NC 28504-6854
(252) 521-0773
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P015383
NC
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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