Provider Demographics
NPI:1548663198
Name:MAZZOLENI, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MAZZOLENI
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 1:800 OLD POND RD
Mailing Address - Street 2:SUITE 702A
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-3415
Mailing Address - Country:US
Mailing Address - Phone:412-221-7770
Mailing Address - Fax:412-221-7773
Practice Address - Street 1:800 OLD POND RD
Practice Address - Street 2:SUITE 702A
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-3415
Practice Address - Country:US
Practice Address - Phone:412-221-7770
Practice Address - Fax:412-221-7773
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007339101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional