Provider Demographics
NPI:1568024206
Name:RIZZA, DOMENICA (LICSW)
Entity Type:Individual
Prefix:
First Name:DOMENICA
Middle Name:
Last Name:RIZZA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 HAYDEN ROWE ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2808
Mailing Address - Country:US
Mailing Address - Phone:774-278-3891
Mailing Address - Fax:
Practice Address - Street 1:194 HAYDEN ROWE ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-2808
Practice Address - Country:US
Practice Address - Phone:774-278-3891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2227411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical