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NPI Code Detail

MEDICARE: COSETTE RAZELLE MIZE CBT

MEDICARE:   COSETTE RAZELLE MIZE  CBT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianCB70117298WA

General Provider Information

NPI Number : 1467398354
Entity Type Code : Individual
Provider Name (Legal Business Name) : COSETTE RAZELLE MIZE CBT
Provider Business Mailing Address
First Line : 11705 N ATLANTIC ST
Second Line :
City : SPOKANE
State : WA
Zip : 99218-1955
Country : US
Telephone Number : 509-714-7761
Fax Number :
Provider Business Practice Location Address
First Line : 111 E CENTRAL AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99208-1108
Country : US
Telephone Number : 509-505-9614
Fax Number : 509-960-5916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2026
Last Update Date : 04/24/2026

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Directions to “ COSETTE RAZELLE MIZE CBT” Practice Location

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