Provider Demographics
NPI:1144486697
Name:GARRISON, WHITNEY LEIGH (OTR)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEIGH
Last Name:GARRISON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 OLYMPIC LOOP APT 201
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5754
Mailing Address - Country:US
Mailing Address - Phone:479-521-8326
Mailing Address - Fax:479-521-5439
Practice Address - Street 1:2474 E JOYCE BLVD
Practice Address - Street 2:STE. 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4519
Practice Address - Country:US
Practice Address - Phone:479-521-8326
Practice Address - Fax:479-521-5439
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARO-TO-820OtherSTATE LICENSE