Provider Demographics
NPI:1861893513
Name:RIZZO, JULIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:RIZZO
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 1:640 E PONCE DE LEON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1976
Mailing Address - Country:US
Mailing Address - Phone:508-523-8198
Mailing Address - Fax:
Practice Address - Street 1:40 FRANKLIN ST STE 400
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1024
Practice Address - Country:US
Practice Address - Phone:678-653-4487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004289103TC1900X, 103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist