Provider Demographics
NPI:1275045254
Name:WHITNEY, MEREDITH (LMT)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04643-3009
Mailing Address - Country:US
Mailing Address - Phone:207-598-8581
Mailing Address - Fax:
Practice Address - Street 1:1350 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04643-3009
Practice Address - Country:US
Practice Address - Phone:207-598-8581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-30
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-22207225700000X
MEMT7215225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist