Individual
DILETTA MOUZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 N FRANKLIN ST STE B, MADISON, NC 27025-1968
(336) 275-7973
Mailing address
2617 LEWIS ST, WINSTON SALEM, NC 27107-4324
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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