Provider Demographics
NPI:1609115690
Name:RIGAZIO, LISA LUE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:LUE
Last Name:RIGAZIO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14855 W LUNA DR N
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-2750
Mailing Address - Country:US
Mailing Address - Phone:305-299-3051
Mailing Address - Fax:
Practice Address - Street 1:14855 W LUNA DR N
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-2750
Practice Address - Country:US
Practice Address - Phone:305-299-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5026314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility