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Organization
CANDACE MIZAUR LLC
Active
Organization
CANDACE MIZAUR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDACE MIZAUR PLMHP (OWNER)
(402) 807-0228
Entity
Organization
Contact information
Practice address
9819 S 168TH AVE STE 6F, OMAHA, NE 68136-1154
(402) 807-0228
Mailing address
9819 S 168TH AVE STE 6F, OMAHA, NE 68136-1154
(402) 807-0228
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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