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Organization
MIZANI THERAPEUTIC SERVICES, LLC
Active
Organization
MIZANI THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHLOE S. GLISPIE- GOGINS (CEO)
(773) 916-6513
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD # 5051, SPRINGFIELD, IL 62704-4188
(773) 916-6513
Mailing address
2501 CHATHAM RD # 5051, SPRINGFIELD, IL 62704-4188
(773) 916-6513
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
09/04/2024
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