Provider Demographics
NPI:1306491030
Name:STOKES, WHITNEY LAUREN (OTR/L)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LAUREN
Last Name:STOKES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:WHITNEY
Other - Middle Name:LAUREN
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:10340 ROAD 1711
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-7817
Mailing Address - Country:US
Mailing Address - Phone:601-416-3323
Mailing Address - Fax:
Practice Address - Street 1:1001 HOLLAND AVE # 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-2161
Practice Address - Country:US
Practice Address - Phone:601-663-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT3723225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist