Provider Demographics
NPI:1396952396
Name:WHITTLE, MARIA HOPE (OTR)
Entity type:Individual
Prefix:MR
First Name:MARIA
Middle Name:HOPE
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24565 ROSEBUD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-1117
Mailing Address - Country:US
Mailing Address - Phone:586-776-2197
Mailing Address - Fax:
Practice Address - Street 1:24565 ROSEBUD AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1117
Practice Address - Country:US
Practice Address - Phone:586-776-2197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201004856171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor