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Individual

TINA L MIZLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2167
Mailing address
51173 CENTRAL VILLAGE RD APT 304, CHESTERFIELD, MI 48047-3575
(586) 961-3167

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
11/17/2023
Last updated
07/26/2024
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