| Tanya D Mizell, NCC LPC CCTP ASDI | |
| 
					3763 17th St, Ecorse, MI 48229-1339  | |
| (734) 237-7199 | |
| Not Available | 
| Full Name | Tanya D Mizell | 
|---|---|
| Gender | Female | 
| Speciality | Counselor - Professional | 
| Location | 3763 17th St, Ecorse, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1306316724 | NPI | - | NPPES | 
| 1732823 | Other | NATIONAL BOARD FOR CERTIFIED COUNSELORS (NBCC) | |
| 7A7B6 | Other | CAGE/NCAGE | |
| KLDNLGNS98C3 | Other | SAM UNIQUE ENTITY ID | |
| 14898250 | Other | CAQH PROVIEW | 
| Entity Name | Unwavering Support Services, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1861250490 PECOS PAC ID: 4688013436 Enrollment ID: O20240412003648  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tanya D Mizell, NCC LPC CCTP ASDI 3763 17th St, Ecorse, MI 48229-1339 Ph: (734) 237-7199  | Tanya D Mizell, NCC LPC CCTP ASDI 3763 17th St, Ecorse, MI 48229-1339 Ph: (734) 237-7199  | 
Mr. Charles E Wasson,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500  | |
Jesus Ontiveroz,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 4646 W Jefferson Ave, Ecorse, MI 48229 Phone: 313-622-9827  | |
Mr. Robert Christopher Miles,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500  | |
Mrs. Rozalyn Marie Mitchell,  Counselor Medicare: Not Enrolled in Medicare Practice Location: 336 Salliotte Rd, Ecorse, MI 48229 Phone: 313-383-5500  |