Individual
DR. MITZI L. WOOD-VON MIZENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
395 INTERSTATE DR, MANCHESTER, TN 37355-3108
(615) 673-6737
(615) 296-4567
Mailing address
3907 BONNAVISTA DR, HERMITAGE, TN 37076-1122
(615) 673-6737
(615) 296-4567
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2192
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3689125
—
TN
05
—
3689127
—
TN
Enumeration date
07/26/2006
Last updated
07/09/2007
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