| Ashlee Mickelson Llc | |
|
504 S 4th St Laramie WY 82070-3704 | |
| (307) 755-1000 | |
| Not Available |
| Full Name | Ashlee Mickelson Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 504 S 4th St, Laramie, Wyoming |
| Authorized Official Name and Position | Ashlee Mickelson (OWNER/THERAPIST) |
| Authorized Official Contact | 3072723515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashlee Mickelson Llc 610 S 5th St Laramie WY 82070-3720 Ph: (307) 272-3515 | Ashlee Mickelson Llc 504 S 4th St Laramie WY 82070-3704 Ph: (307) 755-1000 |
| NPI Number | 1316458540 |
|---|---|
| Provider Enumeration Date | 10/15/2017 |
| Last Update Date | 10/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316458540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LCSW-820 (Wyoming) | Primary |
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