Healthcare Provider Details

I. General information

NPI: 1497692842
Provider Name (Legal Business Name): KRISTA KARLOVIC WHITING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N MECCA ST
CORTLAND OH
44410-1074
US

IV. Provider business mailing address

205 LOUIS BLVD
CORTLAND OH
44410-8765
US

V. Phone/Fax

Practice location:
  • Phone: 330-638-2420
  • Fax:
Mailing address:
  • Phone: 440-812-3437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number002020
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: