Individual
DAVID JOHN MAZZOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3151 E HOLLADAY ST, TUCSON, AZ 85706-2819
(520) 889-2453
Mailing address
3151 E HOLLADAY ST, TUCSON, AZ 85706-2819
(520) 889-2453
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
9209
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
894429
—
AZ
Enumeration date
07/03/2007
Last updated
07/09/2007
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