Provider Demographics
NPI:1437852555
Name:JEAN-MICHEL, LOUIS MOUZIN
Entity Type:Individual
Prefix:
First Name:LOUIS MOUZIN
Middle Name:
Last Name:JEAN-MICHEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 GEORGETOWNE PL
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1047
Mailing Address - Country:US
Mailing Address - Phone:617-259-6431
Mailing Address - Fax:
Practice Address - Street 1:156 GEORGETOWNE PL
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-1047
Practice Address - Country:US
Practice Address - Phone:617-259-6431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289791163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health