# CHILD PROVIDER SPECIALISTS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942540257
- **Authorized official:** DR. MICHAEL PATRICK RIZZO PH.D. (OWNER/LICENSED SCHOOL PSYCHOLOGIST)
- **Authorized official phone:** (954) 385-6292

## Contact information

- **Practice address:** 2771 EXECUTIVE PARK DR, SUITE \#5, WESTON, FL 33331-3642
- **Practice address phone:** (954) 577-3396
- **Mailing address:** 2771 EXECUTIVE PARK DR, SUITE \#5, WESTON, FL 33331-3642
- **Mailing address phone:** (954) 577-3396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC1900X | Counseling Psychologist | SS480 | FL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PY5889 | FL | Yes |

## Other

- **Enumeration date:** 02/22/2013
- **Last updated:** 02/22/2013