Provider Demographics
NPI:1235480195
Name:PEZZAROSSI, CAROLINE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:M
Last Name:PEZZAROSSI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 MARYLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5335
Mailing Address - Country:US
Mailing Address - Phone:202-478-9627
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:301-495-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist