Provider Information for 1295367738
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Mr. ANTHONY MUCCI MA, LMHC, LPC
Sex: Male
NPI: 1295367738
Last Updated: 2024-04-30
Certification Date: 2024-04-30
Certification Date: 2024-04-30
Details
| Name | Value | ||||||||||||||||
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| NPI | 1295367738 | ||||||||||||||||
| Enumeration Date | 2020-02-11 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 179 BROAD ST CONNEAUT, OH 44030-2614 United States Phone: 440-681-2041 | Fax: | ||||||||||||||||
| Primary Practice Address | 179 BROAD ST CONNEAUT, OH 44030-2614 United States Phone: 440-487-7930 | Fax: | ||||||||||||||||
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