Individual
MRS. JENNIFER K MIZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
6711 BUGLE RUN, OAK RIDGE, NC 27310-9753
(336) 312-2705
Mailing address
6711 BUGLE RUN, OAK RIDGE, NC 27310-9753
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
011585
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235Z00000X
TAXONOMY
—
Enumeration date
03/11/2019
Last updated
06/11/2019
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