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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

WALTER J MICKULICK, M.A., MPA

Active Sole Proprietor

WALTER J MICKULICK, M.A., MPA is a Forensic Psychologist healthcare provider located in CHATTANOOGA, Tennessee. NPI 1043578123 is currently active in the NPPES registry. Verify at CMS.

Forensic Psychologist · CHATTANOOGA, TN

Registration Details

NPI Number
1043578123
Provider Type
Individual
Gender
Male
NPI Issued
Apr 26, 2012 (14.315868228441 yrs)
Last Updated
Apr 26, 2012
Licenses
7147485 (TN)
7137531 (TN)
7696871 (TN)
7147485 (TN)
Sole Proprietor
Yes

Practice Information

Address
5600 BRAINERD RD STE B42
CHATTANOOGA, TN, 374115356
Browse TN providers · Browse ZIP 37411
Phone
4236051855
Fax
4232966515
Primary Specialty
Forensic Psychologist
103TF0200X
Additional Specialty
Clinical Psychologist
Additional Specialty
Forensic Psychologist
Additional Specialty
School Psychologist

Other Forensic Psychologist Providers in CHATTANOOGA, TN

Name Credential NPI
WILLIAM MICHAEL HILLNER PHD 1699748954
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.