| NPI | 1649338187 |
|---|---|
| Former Name | CAMILLE ANN MAZZEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 2908) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 731) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-07-08 |