TANYA MICKLER, PH.D, P.A.
Social Work at 91 Ter, Gainesville, FL

License number
Florida PY5842
Category
Social Work
Type
Clinical
Owner
Name: MRS. NORMA BOX
Title: OFFICE MANAGER
Phone: (352) 337-0551
Address
Address
4965 SW 91St Ter SUITE A, Gainesville, FL 32608
National Provider ID: 1356513055
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Tanya Mickler, PH.D., PA

Gainesville, FL

Registration:
Dec 24, 2002
Addresses:
5300 SW 91 Ter, Gainesville, FL 32608
2653 SW 87 Dr, Gainesville, FL 32608
State ID:
P02000133947
Business type:
Domestic for Profit Corporation
Chairman, Vice Presidents:
Tanya J. Mickler (Chairman, President, Secretary),Jon C. Mickler Chairman, Vice President, inactive

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