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Individual

WHITNEY SHEPHERD WHITTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3556 RIVERSIDE DR, BLDG C, MACON, GA 31210-2509
(478) 475-7988
(478) 475-7974
Mailing address
PO BOX 6957, MACON, GA 31208-6957
(478) 475-7988
(478) 475-7974

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004989
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
393197713A
GA
Enumeration date
10/22/2009
Last updated
03/24/2010
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