Healthcare Provider Details

I. General information

NPI: 1811069313
Provider Name (Legal Business Name): BONNIE L PRIZIO M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 CENTRAL ST
LOWELL MA
01852-1910
US

IV. Provider business mailing address

235 WOODLAND N
LYNN MA
01904-1414
US

V. Phone/Fax

Practice location:
  • Phone: 781-715-6608
  • Fax: 781-268-5070
Mailing address:
  • Phone: 781-715-6608
  • Fax: 781-268-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: