Provider Demographics
NPI:1013262278
Name:RIZZUTO, REBECCA CORINNE (ADVANCED MASSAGE PRA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CORINNE
Last Name:RIZZUTO
Suffix:
Gender:F
Credentials:ADVANCED MASSAGE PRA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3747 MINNEHAHA AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2858
Mailing Address - Country:US
Mailing Address - Phone:415-690-0614
Mailing Address - Fax:
Practice Address - Street 1:3747 MINNEHAHA AVE STE 207
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2858
Practice Address - Country:US
Practice Address - Phone:415-690-0614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist