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Individual

VINCENT G MAZZOCCOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2021038375
LMSW
MO
Enumeration date
02/14/2022
Last updated
02/14/2022
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