Provider Demographics
NPI:1184190175
Name:WHITEMAN, ALYSSA DANIELLE (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:DANIELLE
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10839 QUARRY PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4681
Mailing Address - Country:US
Mailing Address - Phone:257-621-6260
Mailing Address - Fax:
Practice Address - Street 1:10839 QUARRY PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4681
Practice Address - Country:US
Practice Address - Phone:210-257-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119350225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics