| Rachel Mickelson | |
|
2106 Ironwood Cir South Bend IN 46635-1864 | |
| (574) 243-9370 | |
| Not Available |
| Full Name | Rachel Mickelson |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2106 Ironwood Cir, South Bend, Indiana |
| Authorized Official Name and Position | Rachel Lynn Mickelson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5742439370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rachel Mickelson 2106 Ironwood Cir South Bend IN 46635-1864 Ph: () - | Rachel Mickelson 2106 Ironwood Cir South Bend IN 46635-1864 Ph: (574) 243-9370 |
| NPI Number | 1245585157 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 07/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245585157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 20042493A (Indiana) | Primary |
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