Provider Demographics
NPI:1174165302
Name:ALLEN, WHITNEY (OT)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:CARADINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-777-6236
Mailing Address - Fax:423-777-6236
Practice Address - Street 1:1476 W GOVERNMENT ST STE B
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-3051
Practice Address - Country:US
Practice Address - Phone:019-146-4406
Practice Address - Fax:601-914-9223
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSTA3714224Z00000X
MSOT-4086225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant