Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 231094 | MA |
NPI | 1053355958 |
---|---|
Provider Name | Sharon A Mozian |
First Address | Pittsfield, MA 01201-4109 |
Second Address | Pittsfield, MA 01201-4109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 12/09/2007 |