Provider Demographics
NPI:1912312513
Name:LANDINO, RAETTA R
Entity Type:Individual
Prefix:MRS
First Name:RAETTA
Middle Name:R
Last Name:LANDINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAETTA
Other - Middle Name:R
Other - Last Name:HORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:575 S CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3019
Mailing Address - Country:US
Mailing Address - Phone:330-666-5866
Mailing Address - Fax:330-666-5801
Practice Address - Street 1:575 S CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3019
Practice Address - Country:US
Practice Address - Phone:330-666-5866
Practice Address - Fax:330-666-5801
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist