Provider Demographics
NPI:1386052009
Name:RIZZOLO, ALLENE
Entity type:Individual
Prefix:
First Name:ALLENE
Middle Name:
Last Name:RIZZOLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 WILLIAM ST APT 33
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2683
Mailing Address - Country:US
Mailing Address - Phone:774-823-5943
Mailing Address - Fax:
Practice Address - Street 1:548 PARK AVE.
Practice Address - Street 2:SOUTH BAY EARLY INTERVENTION
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609
Practice Address - Country:US
Practice Address - Phone:774-823-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency