Individual
KALIYANA MAZZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-16850
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
AZ
Enumeration date
05/21/2019
Last updated
01/16/2020
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