Provider Demographics
NPI:1972903102
Name:JANNAZZO, RACHEL (MA)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:
Last Name:JANNAZZO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 CHICAGO AVE STE 3D
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-4255
Mailing Address - Country:US
Mailing Address - Phone:651-538-6402
Mailing Address - Fax:651-203-7377
Practice Address - Street 1:4749 CHICAGO AVE STE 3D
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-4255
Practice Address - Country:US
Practice Address - Phone:651-538-6402
Practice Address - Fax:651-203-7377
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health