Provider Demographics
NPI:1851032684
Name:ESPELAND, MIKEL
Entity Type:Individual
Prefix:
First Name:MIKEL
Middle Name:
Last Name:ESPELAND
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:PO BOX 12644
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-0028
Mailing Address - Country:US
Mailing Address - Phone:602-290-3656
Mailing Address - Fax:
Practice Address - Street 1:1017 S GILBERT RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4442
Practice Address - Country:US
Practice Address - Phone:425-761-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor