Provider Demographics
NPI:1770006074
Name:LIPP, WHITNEY JUSTINE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JUSTINE
Last Name:LIPP
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:JUSTINE
Other - Last Name:PISANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5415 COUNTY ROAD 30
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-7964
Mailing Address - Country:US
Mailing Address - Phone:585-394-9510
Mailing Address - Fax:585-394-5326
Practice Address - Street 1:5415 COUNTY ROAD 30
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-7964
Practice Address - Country:US
Practice Address - Phone:585-394-9510
Practice Address - Fax:585-394-5326
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021566-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021566-1OtherOFFICE OF PROFESSIONS