Individual provider · Type 1 NPI
Tracy Mazique, MCC
Mental Health Counselor · Philadelphia, PA
NPI number
1629342704
Active
Practice location
5856 Chew Ave
Philadelphia, PA 19138-1736
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1629342704
Tracy Mazique, MCC's National Provider Identifier is 1629342704, issued on Mar 7, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 7, 2012.