Provider Demographics
NPI:1336711266
Name:RIZZO, RACHEL ANN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:RIZZO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SOUTHFIELD AVE APT 137
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-7268
Mailing Address - Country:US
Mailing Address - Phone:203-997-1776
Mailing Address - Fax:
Practice Address - Street 1:39 SMITH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2838
Practice Address - Country:US
Practice Address - Phone:914-244-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist