Provider Demographics
NPI:1871918425
Name:VITUCCI, ANGELINA MARY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:MARY
Last Name:VITUCCI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:VITUCCI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2145 CENTRAL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45214
Mailing Address - Country:US
Mailing Address - Phone:513-910-9465
Mailing Address - Fax:513-721-7529
Practice Address - Street 1:2145 CENTRAL PARKWAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45214
Practice Address - Country:US
Practice Address - Phone:513-910-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8579225X00000X
OHOT.008579225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics