Provider Demographics
NPI:1346922978
Name:SINK, MIKAYLE ALESA
Entity Type:Individual
Prefix:
First Name:MIKAYLE
Middle Name:ALESA
Last Name:SINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5133 PEACEKEEPER RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-7928
Mailing Address - Country:US
Mailing Address - Phone:229-506-1042
Mailing Address - Fax:
Practice Address - Street 1:821 W PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-2537
Practice Address - Country:US
Practice Address - Phone:307-421-9329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor