Individual
JESSICA MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 BROADWAY ST, GLOVERSVILLE, NY 12078-3968
(518) 605-8522
Mailing address
91 W STATE ST EXT, GLOVERSVILLE, NY 12078-1025
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
40934
NY
Other
Enumeration date
10/20/2025
Last updated
10/20/2025
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