Individual
TARA R WHYTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
68 RUSSELL ST, CHARLESTOWN, MA 02129-2144
(617) 829-3003
Mailing address
68 RUSSELL ST, CHARLESTOWN, MA 02129-2144
(617) 829-3003
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
015229
NY
225X00000X
Occupational Therapist
Primary
10347
MA
225XP0200X
Pediatric Occupational Therapist
015229-1
NY
Other
Enumeration date
11/01/2008
Last updated
08/02/2021
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