Provider Demographics
NPI:1316340847
Name:MAZZEI, RAE (PSYD, BCB)
Entity type:Individual
Prefix:DR
First Name:RAE
Middle Name:
Last Name:MAZZEI
Suffix:
Gender:F
Credentials:PSYD, BCB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3377 S PRICE RD STE 2104
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-3573
Mailing Address - Country:US
Mailing Address - Phone:480-448-6755
Mailing Address - Fax:
Practice Address - Street 1:3377 S PRICE RD STE 2104
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-3573
Practice Address - Country:US
Practice Address - Phone:480-448-6755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178009902101YM0800X
IL071009211103TC0700X
AZPSY-004990103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health