Healthcare Provider Details

I. General information

NPI: 1104723923
Provider Name (Legal Business Name): MAZMAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2026
Last Update Date: 10/23/2026
Certification Date: 10/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 CONANT LN
CENTERVILLE MA
02632-1503
US

IV. Provider business mailing address

33 CONANT LN
CENTERVILLE MA
02632-1503
US

V. Phone/Fax

Practice location:
  • Phone: 774-208-3772
  • Fax:
Mailing address:
  • Phone: 774-208-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MAKIESHA BURNETT-MORLE
Title or Position: OWNER
Credential: LICSW
Phone: 774-208-3772