Provider Demographics
NPI:1386072767
Name:MARSHALL, WHITNEY
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2200 KERNAN DR
Mailing Address - Street 2:SUITE G 812
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6665
Mailing Address - Country:US
Mailing Address - Phone:410-448-6323
Mailing Address - Fax:410-448-6338
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:SUITE G 812
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6323
Practice Address - Fax:410-448-6338
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD093-57-5100Medicaid