Provider Demographics
NPI:1891099891
Name:TERRY, WHITNEY ALYSSA (COTA)
Entity Type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:ALYSSA
Last Name:TERRY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 E IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:ONAWA
Mailing Address - State:IA
Mailing Address - Zip Code:51040-8662
Mailing Address - Country:US
Mailing Address - Phone:712-899-0155
Mailing Address - Fax:
Practice Address - Street 1:660 E IOWA AVE
Practice Address - Street 2:
Practice Address - City:ONAWA
Practice Address - State:IA
Practice Address - Zip Code:51040-8662
Practice Address - Country:US
Practice Address - Phone:712-899-0155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000846224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant