Individual
MS. TYANA LASHUN MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, MSCJ
Contact information
Practice address
982 FOREST PATH, STONE MTN, GA 30088-2609
(770) 875-0721
(770) 676-5860
Mailing address
982 FOREST PATH, STONE MTN, GA 30088-2609
(770) 875-0721
(770) 676-5860
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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