Provider Demographics
NPI:1609498708
Name:PRESCOTT, WHITNEY (LMT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11525 HAYNES BRIDGE RD STE 120
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-4822
Mailing Address - Country:US
Mailing Address - Phone:770-772-3500
Mailing Address - Fax:
Practice Address - Street 1:11525 HAYNES BRIDGE RD STE 120
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-4822
Practice Address - Country:US
Practice Address - Phone:770-772-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT010021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist