Individual
TANDI JEAN MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
420 W FEDERAL ST, SHAWNEE, OK 74804-3626
(405) 640-7954
Mailing address
20 SENECA DR, SHAWNEE, OK 74801-5571
(405) 640-7954
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
5268
OK
1041C0700X
Clinical Social Worker
Primary
5628
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/12/2013
Last updated
03/31/2022
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