Individual
MR. JERRY LEE MIZE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2709 POPLAR HAVEN CT, RICHMOND, VA 23223-2172
(804) 691-6957
Mailing address
2709 POPLAR HAVEN CT, RICHMOND, VA 23223-2172
(804) 691-6957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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