Individual
DR. JOHN ARTHUR MAZZOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
443 MAIN STREET, LEWISTON, ME 04240-6733
(207) 783-7081
(207) 783-0500
Mailing address
42 CHURCH HILL ROAD, LEEDS, ME 04263-3416
(207) 524-3261
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS355
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003607
ANTHEM BCBS
ME
Enumeration date
09/15/2006
Last updated
07/08/2007
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