Individual
TRACI RIZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PMHNP-BC
Contact information
Practice address
24715 LITTLE MACK AVE STE 200, SAINT CLAIR SHORES, MI 48080-3207
(586) 777-9000
(586) 777-0823
Mailing address
22198 28 MILE RD, RAY, MI 48096-3227
(586) 777-9000
(586) 777-0823
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704256399
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025029451
MI
Other
Enumeration date
10/02/2019
Last updated
05/19/2026
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