Individual
ANTONIA MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 294-3745
Mailing address
5416 STIRRUP WAY, POWDER SPRINGS, GA 30127-4083
(305) 788-6886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC008556
GA
Other
Enumeration date
11/13/2015
Last updated
10/15/2019
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