Individual
MS. CARLA LISA MIZRAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5104 AVINE CT, WILMINGTON, NC 28409-2727
(917) 509-0920
Mailing address
5104 AVINE CT, WILMINGTON, NC 28409-2727
(917) 509-0920
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8567
NC
222Q00000X
Developmental Therapist
1-11-8567
NC
Other
Enumeration date
08/31/2011
Last updated
08/31/2015
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