Individual
JOHN RICHARD MAZARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, CADC III
Contact information
Practice address
611 SISKIYOU BLVD, ASHLAND, OR 97520-2151
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5382
OR
Other
Enumeration date
08/05/2014
Last updated
02/09/2024
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