Most Relevant Information
Provider Data
| NPI Number: | 1003425471 |
| Provider Name: | AVA MICKOLA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/30/2020 |
| Last Updated: | 07/30/2020 |
Provider Practice Location
27777 INKSTER RD STE 100
FARMINGTON HILLS
MI
483345326
Practice Location Phone/Fax
| Phone: | 2484364400 |
| Fax: |
Provider Mailing Location
27777 INKSTER RD STE 100
FARMINGTON HILLS
MI
483345326
Provider Mailing Phone/Fax
| Phone: | 2484364400 |
| Fax: |