Doctor Name: | MS. KAREN MICKA |
NPI Number: | 1053733402 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.P.C.C. |
License Number: | E. 0002658 |
Business Practice Address: | 2555 S Dixie Dr Suite 108 Kettering, OH - 454091539 |
Business Phone Number: | 9372996060 |
Business Fax Number: | 9372993040 |
Mailing Address: | 2555 S Dixie Dr, Suite 108 KETTERING |
State: | OH |
Postal Code: | 454091539 |
Phone Number: | 9372996060 |
Fax Number: | 9372993040 |
NPI Enumeration Date: | 01/19/2014 |
NPI Last Update Date: | 01/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | E. 0002658 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |