Provider Demographics
NPI:1457758989
Name:WHITE, ANNA LILLIAN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:LILLIAN
Last Name:WHITE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:LILLIAN
Other - Last Name:PHELIX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:116 NEWROCK CRK
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3911
Mailing Address - Country:US
Mailing Address - Phone:210-367-8936
Mailing Address - Fax:
Practice Address - Street 1:15911 NACOGDOCHES RD BLDG 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1107
Practice Address - Country:US
Practice Address - Phone:210-599-7733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114783225X00000X
MA11275225X00000X
RIOT00151-T225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist