Individual
TAYLOR MARIE MIZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC, LLMFT
Contact information
Practice address
481 KENMOOR AVE SE, SUITE C, GRAND RAPIDS, MI 49546
(616) 401-5956
Mailing address
481 KENMOOR AVE SE, SUITE C, GRAND RAPIDS, MI 49546
(616) 401-5956
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451022281
MI
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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