Provider Demographics
NPI:1518576966
Name:MCKNIGHT, WHITNEY ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ANN
Last Name:MCKNIGHT
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 1:345 MIMS RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-5613
Mailing Address - Country:US
Mailing Address - Phone:850-544-2123
Mailing Address - Fax:
Practice Address - Street 1:345 MIMS RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-5613
Practice Address - Country:US
Practice Address - Phone:850-544-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT21144225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT21144OtherFLORIDA DEPARTMENT OF HEALTH