Provider Demographics
NPI:1790354363
Name:RIZZO, JENIFER ANN
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:ANN
Last Name:RIZZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4417 E JOHN ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-0061
Mailing Address - Country:US
Mailing Address - Phone:480-735-8346
Mailing Address - Fax:
Practice Address - Street 1:4417 E JOHN ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0061
Practice Address - Country:US
Practice Address - Phone:480-735-8346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor