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General NPI Number Information
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NPI Number | 1861893513
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Entity Type | Individual
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Provider Name | JULIA RIZZO PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 05/27/2024
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Provider Practice Location Address
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Address Line | 40 FRANKLIN ST STE 400
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City | AVONDALE ESTATES
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State | GA
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Zip | 30002-1024
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Country | US
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Telephone | 678-653-4487
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Fax |
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Provider Business Mailing Address
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Address Line | 640 E PONCE DE LEON AVE APT 1
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City | DECATUR
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State | GA
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Zip | 30030-1976
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Country | US
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Telephone | 508-523-8198
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY004289
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License Number State | GA
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