Doctor Name: | MRS. TIFFANY ANNE MAZZOLI |
NPI Number: | 1245509538 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 100 E Meadow Ln Waveland, MS - 395763238 |
Business Phone Number: | 2283427892 |
Business Fax Number: | |
Mailing Address: | 100 E Meadow Ln, WAVELAND |
State: | MS |
Postal Code: | 395763238 |
Phone Number: | 2283427892 |
Fax Number: | |
NPI Enumeration Date: | 12/15/2011 |
NPI Last Update Date: | 12/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |