Individual
JASON MUZZILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
152 E REYNOLDS RD STE 103, LEXINGTON, KY 40517-1261
(859) 322-9222
Mailing address
205 CHESTNUT RIDGE DR, LEXINGTON, KY 40511-8817
(859) 322-9222
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
252362
KY
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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