Individual
MS. ANDREA LYNN MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232
(503) 238-0759
Mailing address
847 NE 19TH AVE STE 100, PORTLAND, OR 97232-2684
(503) 957-5947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
L7328
OR
1041C0700X
Clinical Social Worker
74768
CA
1041C0700X
Clinical Social Worker
Primary
L7328
OR
Other
Enumeration date
07/31/2011
Last updated
01/03/2019
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