Individual
JENNIFER L MIZICKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCC, LSW
Contact information
Practice address
4450 BELDEN VILLAGE ST NW, SUITE 304, CANTON, OH 44718-2552
(330) 705-2550
Mailing address
3930 THUNDERBIRD CR NW, NORTH CANTON, OH 44720
(330) 705-2550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0004223
OH
101YM0800X
Mental Health Counselor
S0018066
OH
Other
Enumeration date
02/19/2009
Last updated
11/01/2022
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