Provider Demographics
NPI:1588218838
Name:RIZZO, PAUL KIRBY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:KIRBY
Last Name:RIZZO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 FIRST ST APT 927
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1683
Mailing Address - Country:US
Mailing Address - Phone:704-351-0876
Mailing Address - Fax:
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 825
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1741
Practice Address - Country:US
Practice Address - Phone:202-986-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1001517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical