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General NPI Number Information
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NPI Number | 1730628058
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Entity Type | Individual
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Provider Name | JACQUELYN RIZZO
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Gender | Female
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Dates
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Enumeration Date | 02/20/2017
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Last Update Date | 04/04/2017
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Provider Practice Location Address
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Address Line | 1124 NY ROUTE 94 SUITE 201
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City | NEW WINDOSR
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State | NY
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Zip | 12553
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Country | US
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Telephone | 845-787-1350
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 NY ROUTE 94 SUITE 201
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City | NEW WINDSOR
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State | NY
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Zip | 12553
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Country | US
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Telephone | 845-787-1350
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007415-1
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License Number State | NY
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