Provider Demographics
NPI:1316413081
Name:PRINZO, EMILY RACHEL (PSYD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RACHEL
Last Name:PRINZO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 A ST UNIT 5C
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-1870
Mailing Address - Country:US
Mailing Address - Phone:617-548-7662
Mailing Address - Fax:
Practice Address - Street 1:36 A ST UNIT 5C
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-1870
Practice Address - Country:US
Practice Address - Phone:617-548-7662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11667103TC0700X, 103TF0200X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic