Provider Demographics
NPI:1447676648
Name:RIZZATTI, MICHELLE O (CSA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:O
Last Name:RIZZATTI
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:OSBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1205 PARKER DR
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-2909
Mailing Address - Country:US
Mailing Address - Phone:757-636-6691
Mailing Address - Fax:
Practice Address - Street 1:1205 PARKER DR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-2909
Practice Address - Country:US
Practice Address - Phone:757-636-6691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist