Individual
CHARLES MATTHEW MAZICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LGPC
Contact information
Practice address
8894 STANFORD BLVD, COLUMBIA, MD 21045-4794
(443) 718-0059
(347) 903-6927
Mailing address
8894 STANFORD BLVD, COLUMBIA, MD 21045-4794
(347) 903-6927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGP13378
MD
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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