Provider Demographics
NPI:1407378813
Name:RANDAZZO, HANNAH MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:RANDAZZO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:LESSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9990 DOUBLE R BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 E PRATER WAY STE 103
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8973
Practice Address - Country:US
Practice Address - Phone:775-331-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist