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Individual
JACOB PAUL MIZELL
Active
Individual
JACOB PAUL MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11684
KS
1041C0700X
Clinical Social Worker
Primary
06627
KS
1041C0700X
Clinical Social Worker
Primary
11684
KS
Other
Enumeration date
07/17/2020
Last updated
10/16/2026
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