Provider Demographics
NPI:1225421852
Name:WHITEHEAD, BRITTANY MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 MAIN ST.
Mailing Address - Street 2:APT. 306
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0316
Mailing Address - Country:US
Mailing Address - Phone:610-297-0020
Mailing Address - Fax:973-875-4075
Practice Address - Street 1:888 MAIN ST.
Practice Address - Street 2:APT. 306
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0316
Practice Address - Country:US
Practice Address - Phone:610-297-0020
Practice Address - Fax:973-875-4075
Is Sole Proprietor?:No
Enumeration Date:2015-03-06
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63019593225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist