Provider Demographics
NPI:1932710233
Name:MICOZZI, PAOLA (CMT)
Entity Type:Individual
Prefix:MS
First Name:PAOLA
Middle Name:
Last Name:MICOZZI
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 1/2 LA MIRADA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-1404
Mailing Address - Country:US
Mailing Address - Phone:323-745-6541
Mailing Address - Fax:
Practice Address - Street 1:6532 1/2 LA MIRADA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-1404
Practice Address - Country:US
Practice Address - Phone:323-745-6541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist