Individual
EARLINE MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
455 DOUGLAS AVE, SUITE 2155-4, ALTAMONTE SPRINGS, FL 32714-2569
(407) 682-3900
(321) 952-0294
Mailing address
PO BOX 940924, MAITLAND, FL 32794-0924
(407) 682-3900
(321) 952-0294
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
FL
Enumeration date
12/02/2016
Last updated
12/06/2016
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