Individual
AMANDA LEIGH MIZENIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
1630 NEW KINGS BRIDGE RD, ATHENS, GA 30607-3921
(706) 543-8798
Mailing address
61 ROOSEVELT CT, JEFFERSON, GA 30549-7105
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004596
GA
Other
Enumeration date
08/01/2026
Last updated
08/01/2026
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