Provider Demographics
NPI:1962386672
Name:MOZZO, CLARISSA MARIA (MA, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:CLARISSA
Middle Name:MARIA
Last Name:MOZZO
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 AQUEDUCT AVE E
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-1400
Mailing Address - Country:US
Mailing Address - Phone:718-584-5805
Mailing Address - Fax:
Practice Address - Street 1:2200 AQUEDUCT AVE E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1400
Practice Address - Country:US
Practice Address - Phone:718-584-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035812235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist