Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301013390 | MI |
Y | 103G00000X | Clinical Psychologist | 6301013390 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301013390 | MI |
NPI | 1295886042 |
---|---|
Provider Name | Dr. Sara Helene Rizzo |
First Address | Clinton Township, MI 48038-2408 |
Second Address | Detroit, MI 48201-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 30/07/2013 |