Individual
BRIANNA MAZZULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
(718) 948-3232
Mailing address
4 MACON AVE, STATEN ISLAND, NY 10312-2013
(347) 682-6798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1013083476
NY
Other
Enumeration date
11/05/2016
Last updated
11/05/2016
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