Provider Demographics
NPI:1295955243
Name:MUZAROL, AMY CHRISTINE (DEV SPECIALIST)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CHRISTINE
Last Name:MUZAROL
Suffix:
Gender:F
Credentials:DEV SPECIALIST
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:POTVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DEV SPECIALIST
Mailing Address - Street 1:9 EDEN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4706
Mailing Address - Country:US
Mailing Address - Phone:978-741-1896
Mailing Address - Fax:
Practice Address - Street 1:103 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-4001
Practice Address - Country:US
Practice Address - Phone:781-593-2727
Practice Address - Fax:781-593-2542
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist