Individual
MRS. ELIZABETH LOUISE WHITSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
118 HERRON ST, ST OGLETHORPE, GA 30742
(706) 861-7471
(706) 861-7472
Mailing address
118 HERRON ST, ST OGLETHORPE, GA 30742
(706) 861-7471
(706) 861-7472
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004175
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10052407
AMERIGROUP
—
01
—
339903
WELLCARE
—
01
—
4111087
BCBS
TN
01
—
52171868002
BCBS
GA
Enumeration date
12/01/2006
Last updated
07/08/2007
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