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1881430023
AUTUMN KAYLEN MIZE
WAKE FOREST, NC
NPI
1881430023
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Former Name
AUTUMN STEWART
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NC A19989)
Enumeration Date
2024-07-08
Last Update Date
2024-07-08
Business Address
AUTUMN KAYLEN MIZE LCMHC-A
1314 ECOLA VALLEY CT
WAKE FOREST, NC 27587-4915
Phone number: 984-212-2757
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Mailing Address
AUTUMN KAYLEN MIZE LCMHC-A
1314 ECOLA VALLEY CT
WAKE FOREST, NC 27587-4915
Phone number: 984-212-2757
Copy
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