Individual
JENNIFER MAZZOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 747-5223
Mailing address
4840 SUNPOINT CIR APT 610, INDIANAPOLIS, IN 46237-4601
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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