Individual
DELANEY MIZELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 MARINA RD UNIT 323A, IRMO, SC 29063-6920
(321) 419-4519
Mailing address
1600 MARINA RD UNIT 323A, IRMO, SC 29063-6920
(321) 419-4519
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/09/2025
Last updated
09/09/2025
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