Nicholas Mazzoni
Social Worker, Clinical in Canon City, CO. Individual provider (NPI-1).
NPI number1164021853
StatusActive
Last updated in NPPESOct 22, 2020
Details
- NPI
- 1164021853
- Entity type
- Individual (NPI-1)
- Name
- Nicholas Mazzoni
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 22, 2020
- Certification date
- Oct 22, 2020
- Last updated
- Oct 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | – | Yes |
Practice location
700 Four Mile PkwyCanon City, CO 81212-9114
Phone 719-276-7500
Mailing address
431 Woodlawn AveCanon City, CO 81212-2838
Phone 612-432-6098
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