Individual
MRS. BERNICE MAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1510 GUNTER AVE, GUNTERSVILLE, AL 35976-1848
(256) 582-8833
(256) 582-8335
Mailing address
PO BOX 959, GUNTERSVILLE, AL 35976-0959
(256) 582-8833
(256) 582-8335
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
1457C
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051551554
—
AL
01
—
51092776MAZ
BCBS
AL
Enumeration date
08/03/2006
Last updated
09/30/2008
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