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Individual

PROF. PAMALA DAWN MIZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S. CCC-A

Contact information

Practice address
360 VIRGINIA AVE, WYTHEVILLE, VA 24382-1185
(276) 620-3546
(276) 228-3546
Mailing address
195 W PINE ST, # 103, WYTHEVILLE, VA 24382-1954
(276) 620-3546
(276) 228-3546

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201000232
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1518125
FUNDS (UMWA) AUDIOLOGY
VA
01
171991
ANTHEM BCBS AUDIOLOGY
VA
05
9450688
VA
Enumeration date
02/19/2007
Last updated
10/15/2007
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