Mizelle-Johnson, Nathalie Diona
Mizelle-Johnson, Nathalie Diona is an sole proprietor health care provider with primary practice located at 1709 Evans St Suite B, Greenville NC 27834-5772. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Mizelle-Johnson, Nathalie Diona can be contacted via phone (252) 756-7848.Contact Information
Primary practice address
1709 Evans St Suite B
Greenville NC 27834-5772
Phone: (252) 756-7848
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0701006205 | Virginia |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2084 | North Carolina |
Profile Details
| NPI number | 1013117902 |
|---|---|
| LBN Legal business name | Mizelle-Johnson, Nathalie Diona |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2007 |
| Last updated | Apr 2nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013117902 | NPPES |
| North Carolina | MEDICAID | 6103993 |
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