Provider Demographics
NPI:1407370166
Name:WHITE, ARIEL JESSICA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:ARIEL
Middle Name:JESSICA
Last Name:WHITE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:JESSICA
Other - Last Name:OCUBILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1495 WOODLAND TRL
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-6960
Mailing Address - Country:US
Mailing Address - Phone:850-573-0514
Mailing Address - Fax:
Practice Address - Street 1:1567 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-6948
Practice Address - Country:US
Practice Address - Phone:850-638-3387
Practice Address - Fax:850-415-1967
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32780225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist