MEDICARE: MARIE-CHRISTINE NIZZI PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	1588	NH
2	103T00000X	Psychologist	11778	MA
3	103T00000X	Psychologist	112801	IA
4	103T00000X	Psychologist	048.0134435	VT
5	103T00000X	Psychologist	33378	CA

General Provider Information

NPI Number	:	1891434197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE-CHRISTINE NIZZI PHD

Provider Business Mailing Address
First Line	:	30 BANK ST STE 3
Second Line	:
City	:	LEBANON
State	:	NH
Zip	:	03766-1756
Country	:	US
Telephone Number	:	603-585-5047
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 BENNING ST STE 160-170
Second Line	:
City	:	WEST LEBANON
State	:	NH
Zip	:	03784-3402
Country	:	US
Telephone Number	:	857-204-4057
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	02/17/2026

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