Provider Demographics
NPI:1013634765
Name:WHITTAKER, ZOE ISABELLE (COTA)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:ISABELLE
Last Name:WHITTAKER
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 1:312 TEAL LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4749
Mailing Address - Country:US
Mailing Address - Phone:850-766-5435
Mailing Address - Fax:
Practice Address - Street 1:1809 MICCOSUKEE COMMONS DR STE 112
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5461
Practice Address - Country:US
Practice Address - Phone:850-210-1172
Practice Address - Fax:850-210-0047
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL475099224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant