Individual
MR. KERRY LEON MIZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
200 POPLAR AVE, NEWPORT NEWS, VA 23607-5530
(757) 715-4566
Mailing address
200 POPLAR AVE, NEWPORT NEWS, VA 23607-5530
(757) 715-4566
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701008557
VA
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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