Provider Demographics
NPI:1346819620
Name:DESOTELL, WHITNEY LYNN (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LYNN
Last Name:DESOTELL
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 LANTERN LIGHT CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-9008
Mailing Address - Country:US
Mailing Address - Phone:850-459-1704
Mailing Address - Fax:
Practice Address - Street 1:1 PAYCOR STADIUM
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-3492
Practice Address - Country:US
Practice Address - Phone:513-455-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0067812255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer