Individual
MRS. LARISSA LYNN WHITTENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CLC
Contact information
Practice address
1132 HICKORY ST, COLORADO CITY, TX 79512-4912
(325) 728-5312
Mailing address
1210 STATE HIGHWAY 70, SWEETWATER, TX 79556-1728
(325) 725-8338
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120683
TX
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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