Doctor Name: | MS. ANN M. MIKULICH |
NPI Number: | 1023277522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC |
License Number: | PC005705 |
Business Practice Address: | 1607 3rd St Beaver, PA - 150092420 |
Business Phone Number: | 7247288400 |
Business Fax Number: | |
Mailing Address: | 105 Mary Reed Rd, BADEN |
State: | PA |
Postal Code: | 150059612 |
Phone Number: | 7246012367 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2008 |
NPI Last Update Date: | 01/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC005705 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |