Individual
MICHELLE FROST MAZZOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1420 CAMPBELL ST APT 215, RAHWAY, NJ 07065-3291
(732) 742-6256
Mailing address
780 AMERICAN LEGION HWY, ROSLINDALE, MA 02131-3908
(732) 742-6256
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23775
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/30/2011
Last updated
04/22/2019
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