Individual
MRS. MIMI MIZE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S MIDWEST BLVD, SUITE 102, MIDWEST CITY, OK 73110-4946
(318) 402-6799
Mailing address
8121 EAGLE CIR, OKLAHOMA CITY, OK 73135-6077
(318) 402-6799
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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