Provider Demographics
NPI:1952851958
Name:MIZELL, KARLYNN KATHLEEN (MSED, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KARLYNN
Middle Name:KATHLEEN
Last Name:MIZELL
Suffix:
Gender:F
Credentials:MSED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16418 MIAMI ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-2592
Mailing Address - Country:US
Mailing Address - Phone:531-299-8580
Mailing Address - Fax:
Practice Address - Street 1:1616 S 120TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-1630
Practice Address - Country:US
Practice Address - Phone:402-557-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist