Provider Demographics
NPI:1053430694
Name:WHITE, WINFIELD A (OTR)
Entity type:Individual
Prefix:
First Name:WINFIELD
Middle Name:A
Last Name:WHITE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 ALLENTOWN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4521
Mailing Address - Country:US
Mailing Address - Phone:301-520-9376
Mailing Address - Fax:301-203-8530
Practice Address - Street 1:5625 ALLENTOWN RD
Practice Address - Street 2:STE 200
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4521
Practice Address - Country:US
Practice Address - Phone:301-520-9376
Practice Address - Fax:301-203-8530
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT701225X00000X
MD03540225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist