Provider Demographics
NPI:1134831423
Name:WHITEHEAD, ABIGAIL (OTR/L)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5854
Mailing Address - Country:US
Mailing Address - Phone:724-516-2530
Mailing Address - Fax:
Practice Address - Street 1:1118 WOODWARD DR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6416
Practice Address - Country:US
Practice Address - Phone:724-836-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018632225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist