MRS. Tisha Micko
NPI #1972380103 in Belleville, Illinois
Provider Information
- NPI Number
- 1972380103
- Entity Type
- Individual
- Name
- MRS. Tisha Micko
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Sep 11, 2023
- Last Updated
- Dec 5, 2023
Practice Location
- Address
- 624 OAK HILL DR
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62223-2247
- Phone
- (314) 532-5202
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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