Healthcare Provider Details

I. General information

NPI: 1780640763
Provider Name (Legal Business Name): JOSEPH L RIZZO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 02/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6818 GROVER ST SUITE 303
OMAHA NE
68106-3640
US

IV. Provider business mailing address

6818 GROVER ST SUITE 303
OMAHA NE
68106-3640
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-0330
  • Fax: 402-397-8082
Mailing address:
  • Phone: 402-397-0330
  • Fax: 402-397-8082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number12
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: