Individual
SHANNON MAZZEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 SPRING LN, PHILADELPHIA, PA 19128-3918
(215) 482-5353
Mailing address
941 LAURANCE AVE, ELKINS PARK, PA 19027-1920
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
966008
PA
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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