Provider Demographics
NPI:1669409488
Name:TOTO, VANESSA M (PT)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:M
Last Name:TOTO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:M
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:114 TOTO RD
Mailing Address - Street 2:
Mailing Address - City:ADENA
Mailing Address - State:OH
Mailing Address - Zip Code:43901-6944
Mailing Address - Country:US
Mailing Address - Phone:412-417-2537
Mailing Address - Fax:
Practice Address - Street 1:4329 MAHONING AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1910
Practice Address - Country:US
Practice Address - Phone:412-417-2537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014518225100000X
PAPT014314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist