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General NPI Number Information
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NPI Number | 1659719029
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Entity Type | Individual
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Provider Name | DINA MICHELE RIZZO-KORMONDY LPC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 358 WALL ST
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City | PRINCETON
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State | NJ
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Zip | 08540-1517
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Country | US
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Telephone | 609-921-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 23 WINTHROP RD
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City | EDISON
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State | NJ
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Zip | 08817-4018
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Country | US
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Telephone | 732-289-8822
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37AC00147000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00599900
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License Number State | NJ
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