Provider Demographics
NPI:1235903360
Name:WHITE, VICTORIA ANN (OT)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 TOPSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01984-1933
Mailing Address - Country:US
Mailing Address - Phone:203-214-9139
Mailing Address - Fax:
Practice Address - Street 1:370 MERRIMACK ST STE 120
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1789
Practice Address - Country:US
Practice Address - Phone:203-214-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15061225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist