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Individual

MS. CAROL S SHIVELY MIZES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT-BC, NMT FELLOW

Contact information

Practice address
14924 ROYAL RIDGE LN, NORTH ROYALTON, OH 44133-4864
(440) 749-1864
Mailing address
14924 ROYAL RIDGE LN, NORTH ROYALTON, OH 44133-4864
(440) 749-1864

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
07300
OH

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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