Individual
THERESA D MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1201 1ST ST S, WINTER HAVEN, FL 33880-3904
(863) 293-1121
(863) 291-6084
Mailing address
200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
(863) 293-1121
(863) 291-6084
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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