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1255115523
JERRY LEE MIZE
RICHMOND, VA
NPI
1255115523
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-08-18
Last Update Date
2023-08-18
Business Address
Mr. JERRY LEE MIZE
2709 POPLAR HAVEN CT
RICHMOND, VA 23223-2172
Phone number: 804-691-6957
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Mailing Address
Mr. JERRY LEE MIZE
2709 POPLAR HAVEN CT
RICHMOND, VA 23223-2172
Phone number: 804-691-6957
Copy
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