Provider Demographics
NPI:1881904779
Name:GIANOTTO, ANGELA MARIE (LMT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:GIANOTTO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 E UNIVERSITY ST
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-3061
Mailing Address - Country:US
Mailing Address - Phone:330-201-1234
Mailing Address - Fax:
Practice Address - Street 1:146 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-4371
Practice Address - Country:US
Practice Address - Phone:330-466-2725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33016197225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist