Individual
JASON MIZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
3715 NE HIGHWAY 20, CORVALLIS, OR 97330-9209
(303) 880-3745
(813) 441-8362
Mailing address
3715 NE HIGHWAY 20, CORVALLIS, OR 97330-9209
(303) 880-3745
(813) 441-8362
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-280471
OR
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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