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Individual

MACKENZIE MIZELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
6127 MCINTYRE RIDGE DR, CHARLOTTE, NC 28216-8819
(828) 357-7436
Mailing address
6127 MCINTYRE RIDGE DR, CHARLOTTE, NC 28216-8819
(828) 357-7436

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
10054
ID
106H00000X
Marriage & Family Therapist
13609815-3902
UT
106H00000X
Marriage & Family Therapist
Primary
2322
NC
106H00000X
Marriage & Family Therapist
MFT002106
GA

Other

Enumeration date
12/15/2020
Last updated
03/29/2024
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