Provider Demographics
NPI:1619416591
Name:PHILIPP-PIZARRO, JEANETTE (PROGRAM THERAPIST)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:PHILIPP-PIZARRO
Suffix:
Gender:F
Credentials:PROGRAM THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22541 SW 88TH PL UNIT 102
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-2016
Mailing Address - Country:US
Mailing Address - Phone:305-851-1186
Mailing Address - Fax:
Practice Address - Street 1:22541 SW 88TH PL UNIT 102
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-2016
Practice Address - Country:US
Practice Address - Phone:305-851-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health