Mikalson, Mary E

Mikalson, Mary E is an individual health care provider with primary practice located at 705 W Main St Suit 3, Sun Prairie WI 53590-2849. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mikalson, Mary E can be contacted via phone (608) 825-6663.

Contact Information

Primary practice address
705 W Main St Suit 3 Sun Prairie WI 53590-2849
Fax: (608) 825-6946
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2822-123 Wisconsin

Profile Details

NPI number 1790841179
LBN Legal business name Mikalson, Mary E
Credentials Master of Science in Social Work (MSSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790841179 NPPES
Wisconsin MEDICAID 39255200

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