Provider Demographics
NPI:1750651386
Name:CRAIN, MONICA RIZZUTO (MS)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:RIZZUTO
Last Name:CRAIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ANNAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2002
Mailing Address - Country:US
Mailing Address - Phone:620-506-1519
Mailing Address - Fax:
Practice Address - Street 1:301 W I 240 SERVICE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-7701
Practice Address - Country:US
Practice Address - Phone:405-272-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)