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Individual

MR. DARRELL JAMES WHITBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
5415 N BLOOMFIELD RD, HAPPINESS HOUSE, CANANDAIGUA, NY 14424-7964
(585) 394-9510
(585) 394-5326
Mailing address
55 GROTON PKWY, ROCHESTER, NY 14623-4532

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
012505-1
NY
225XN1300X
Neurorehabilitation Occupational Therapist
012505-1
NY
225XP0200X
Pediatric Occupational Therapist
012505-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01635592
NY
Enumeration date
12/22/2006
Last updated
12/10/2015
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