Provider Demographics
NPI:1356569370
Name:ANZOVINO, LINDA V (COTA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:V
Last Name:ANZOVINO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:VAN DRESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:2555 TEAGUE STREET
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092
Mailing Address - Country:US
Mailing Address - Phone:704-732-3590
Mailing Address - Fax:
Practice Address - Street 1:420 NORTH CENTER STREET
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601
Practice Address - Country:US
Practice Address - Phone:828-315-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4985224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant