Wenona H Mickan | Farmington, MO • PECOS Search

Wenona H Mickan

Social Worker

Behavioral Health & Social Service Providers

1085 Maple St, Farmington, MO 63640-1955

PECOS Enrollment

Based on the most recent information from CMS, provider Wenona H Mickan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1013922509
Provider Type
Individual
Full Name
Mickan, Wenona H
Title
Mrs.
Credential
MSW

Gender
Female
Sole Proprietor
No
Enumeration Date
7/31/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1085 Maple St, Farmington, MO 63640-1955

Unlisted Fax

Mailing Location

1430 Olive St, Suite 400, Saint Louis, MO 63103-2303

(573) 756-4361

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer