Individual
JACOB P MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMCSW
Contact information
Practice address
1600 N LORRAINE ST STE 202, HUTCHINSON, KS 67501-5600
(620) 663-7595
(620) 513-5098
Mailing address
1600 N LORRAINE ST STE 202, HUTCHINSON, KS 67501-5600
(620) 663-7595
(620) 513-5098
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
11684
KS
1041C0700X
Clinical Social Worker
Primary
11684
KS
Other
Enumeration date
07/17/2020
Last updated
11/14/2024
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