Provider Demographics
NPI:1477175487
Name:RAZZABONI, JUSTINE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JUSTINE
Middle Name:
Last Name:RAZZABONI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 SHADY SUMMIT WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-4876
Mailing Address - Country:US
Mailing Address - Phone:603-703-7690
Mailing Address - Fax:
Practice Address - Street 1:70 BUTLER ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3925
Practice Address - Country:US
Practice Address - Phone:603-893-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3008225X00000X
NC13519225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist