Individual
CORTLANDT HALSEY MAZZOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED
Contact information
Practice address
4129 DALLAS HUTCHISON ST, CHANTILLY, VA 20151-2944
(301) 304-8825
Mailing address
4129 DALLAS HUTCHISON ST, CHANTILLY, VA 20151-2944
(301) 304-8825
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701013285
VA
101YM0800X
Mental Health Counselor
5694
TN
Other
Enumeration date
03/14/2019
Last updated
08/22/2024
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