Provider Demographics
NPI:1538896824
Name:MAROZZI, MAYA RAINIE
Entity type:Individual
Prefix:MISS
First Name:MAYA
Middle Name:RAINIE
Last Name:MAROZZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 N MAIN ST UNIT 68
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1462
Mailing Address - Country:US
Mailing Address - Phone:860-918-8015
Mailing Address - Fax:
Practice Address - Street 1:85 N MAIN ST UNIT 68
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1462
Practice Address - Country:US
Practice Address - Phone:860-918-8015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician