Individual
SARA JANE S MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1300 S 2ND ST, SUITE 180, MINNEAPOLIS, MN 55454-1075
(612) 625-1500
Mailing address
3989 CENTRAL AVE NE, SUITE 300, COLUMBIA HEIGHTS, MN 55421-3900
(612) 625-1500
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP3799
MN
103TC0700X
Clinical Psychologist
Primary
LP3799
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014760
PREFERRED ONE
MN
01
—
112536
UCARE
MN
05
—
130519100
—
MN
01
—
61-90224
MEDICA CHOICE
MN
01
—
HP48983
HEALTHPARTNERS
MN
01
—
P00326504
RR MEDICARE
MN
Enumeration date
10/26/2006
Last updated
03/11/2021
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