Provider Demographics
NPI:1366498610
Name:RAIMONDI, ERINN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ERINN
Middle Name:
Last Name:RAIMONDI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:ERINN
Other - Middle Name:
Other - Last Name:BALLOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:28 MANVILLE HILL ROAD APT. 1
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864
Mailing Address - Country:US
Mailing Address - Phone:401-447-5427
Mailing Address - Fax:
Practice Address - Street 1:830 CHALKSTONE AVE
Practice Address - Street 2:PROVIDENCE VA MEDICAL CENTER
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-273-7100
Practice Address - Fax:401-525-2529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01008225X00000X
MA0761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist