Mickens, Mary Lane
Mickens, Mary Lane is an sole proprietor health care provider with primary practice located at 5221 N Park Rd , Texarkana TX 75503-2664. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mickens, Mary Lane can be contacted via phone (903) 791-1051.Contact Information
Primary practice address
5221 N Park Rd
Texarkana TX 75503-2664
Phone: (903) 791-1051
Fax: (903) 791-1053
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 19530 | Texas |
Profile Details
| NPI number | 1265594345 |
|---|---|
| LBN Legal business name | Mickens, Mary Lane |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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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