Individual
MR. BASILE BAZINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
142 CRESCENT ST, SECOND FLOOR, BROCKTON, MA 02302-3104
(508) 941-0005
Mailing address
PO BOX 2072, BROCKTON, MA 02305-2072
(774) 826-7416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/12/2012
Last updated
08/12/2012
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