Provider Demographics
NPI:1740370485
Name:RIZZO, COLLEEN CLARKE (MHS OTR/L)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:CLARKE
Last Name:RIZZO
Suffix:
Gender:F
Credentials:MHS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 RT 97
Mailing Address - Street 2:
Mailing Address - City:NARROWSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12764
Mailing Address - Country:US
Mailing Address - Phone:845-252-6673
Mailing Address - Fax:
Practice Address - Street 1:7737 RT 97
Practice Address - Street 2:
Practice Address - City:NARROWSBURG
Practice Address - State:NY
Practice Address - Zip Code:12764
Practice Address - Country:US
Practice Address - Phone:845-252-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005756-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist