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Individual

DR. AYAKO MIZUNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DAOM, LAC

Contact information

Practice address
2500 N MAYFAIR RD STE 410, WAUWATOSA, WI 53226-1415
(414) 687-0087
Mailing address
2500 N MAYFAIR RD STE 410, WAUWATOSA, WI 53226-1415
(414) 687-0087

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171100000X
Acupuncturist
Primary
1002-55
WI
171100000X
Acupuncturist
ACU-1267
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1002-55
LICENSED ACUPUNCTURIST
WI
01
101YM0800X
COUNSELOR
CA
Enumeration date
08/01/2006
Last updated
02/04/2021
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