Provider Demographics
NPI:1487851333
Name:GALLAGHER, WHITNEY E (OTR)
Entity type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:E
Last Name:GALLAGHER
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 1:11 SPRING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39059-9610
Mailing Address - Country:US
Mailing Address - Phone:601-466-2699
Mailing Address - Fax:
Practice Address - Street 1:604 PRINCETON RD
Practice Address - Street 2:#22
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-3760
Practice Address - Country:US
Practice Address - Phone:601-466-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3186225X00000X
MD05676225X00000X
MSOT1808225X00000X
TN3754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist