Individual
SYDNEY RAY WHITTINGSLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/OT
Contact information
Practice address
1326 CHURCH ST, ZACHARY, LA 70791-2743
(225) 654-8208
Mailing address
1326 CHURCH ST, ZACHARY, LA 70791-2743
(225) 654-8208
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
320924
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
320924
OCCUPATIONAL LICENSE
LA
Enumeration date
09/25/2019
Last updated
09/25/2019
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