Rachel Mickelson

NPI #1245585157 in South Bend, Indiana

Provider Information

NPI Number: 1245585157
Entity Type: Organization
Organization Name: Rachel Mickelson
Primary Specialty: Psychologist - Clinical
Enumeration Date: Jul 17, 2012
Last Updated: Jul 17, 2012

Practice Location

Address: 2106 IRONWOOD CIR
City: South Bend
State: Indiana
ZIP Code: 46635-1864
Phone: (574) 243-9370

Authorized Official

Name: RACHEL LYNN MICKELSON, PSYD, HSPP
Title: CLINICAL PSYCHOLOGIST
Phone: (574) 243-9370

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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