Provider Demographics
NPI:1598967218
Name:WILHITE, CARLA SUE (OTR)
Entity Type:Individual
Prefix:MS
First Name:CARLA
Middle Name:SUE
Last Name:WILHITE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 ADAMS ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5047
Mailing Address - Country:US
Mailing Address - Phone:505-252-2585
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO HSSB ROOM 140
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-3324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3050225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist