Individual
GINA C MAZZANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
216 MAIN ST, LAKE VILLAGE, AR 71653-1916
(870) 265-6619
Mailing address
216 MAIN ST, LAKE VILLAGE, AR 71653-1916
(870) 265-6619
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 890
AR
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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