Provider Demographics
NPI:1194064840
Name:WHITE, ANITA MILLER
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:MILLER
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10835 COOL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:NC
Mailing Address - Zip Code:27013-9731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:877 HILL EVERHART RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27295-9140
Practice Address - Country:US
Practice Address - Phone:336-248-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0987224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant