Provider Demographics
NPI:1235279126
Name:RIZK, KATHYLYNN MARIE (MS-CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:KATHYLYNN
Middle Name:MARIE
Last Name:RIZK
Suffix:
Gender:F
Credentials:MS-CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-1064
Mailing Address - Country:US
Mailing Address - Phone:712-252-1201
Mailing Address - Fax:712-252-0512
Practice Address - Street 1:2730 PIERCE ST
Practice Address - Street 2:SUITE 402
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3796
Practice Address - Country:US
Practice Address - Phone:712-252-5203
Practice Address - Fax:712-252-0512
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00439231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist