Healthcare Provider Details

I. General information

NPI: 1366320921
Provider Name (Legal Business Name): GIANA JEAN VITTORISO MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 TOMMYS RD
GOLDSBORO NC
27530-9639
US

IV. Provider business mailing address

262 SWINSON DR
DUDLEY NC
28333-5359
US

V. Phone/Fax

Practice location:
  • Phone: 919-734-8085
  • Fax:
Mailing address:
  • Phone: 781-733-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL14675
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number18508
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: