Individual
CAYLA MITZKOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1280 E CAMPUS DR BLDG 1101, MOUNT PLEASANT, MI 48858-3803
(989) 774-2284
Mailing address
150 OTROBANDO AVE, NORWICH, CT 06360-2116
(860) 889-7274
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
5096
CT
103T00000X
Psychologist
5096
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
DOCTORAL STUDENT
—
Enumeration date
04/09/2020
Last updated
06/18/2025
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