Provider Demographics
NPI:1689001885
Name:WHITTINGTON, ANDREA (COTA/L)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37380 HARMONY DR
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-3801
Mailing Address - Country:US
Mailing Address - Phone:443-235-4368
Mailing Address - Fax:
Practice Address - Street 1:37380 HARMONY DR
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-3801
Practice Address - Country:US
Practice Address - Phone:443-235-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02059224Z00000X
DEU2-0001412224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant