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Individual
MICHAEL MAZANOWSKI
Active
Individual
MICHAEL MAZANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.162022
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCDCIII.162022
LCDCIII
OH
Enumeration date
03/19/2018
Last updated
01/08/2024
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