NPI Code Details Logo

NPI 1255037438

NPI 1255037438 : KATHERINE E WHIDDEN OT : SOUTH PORTLAND, ME

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1255037438
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KATHERINE E WHIDDEN OT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/31/2023
-----------------------------------------------------
    Last Update Date     |    03/12/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    50 FODEN RD 
-----------------------------------------------------
    City                 |    SOUTH PORTLAND
-----------------------------------------------------
    State                |    ME
-----------------------------------------------------
    Zip                  |    04106-1718
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    207-780-8860
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    100 GANNETT DR STE C 
-----------------------------------------------------
    City                 |    SOUTH PORTLAND
-----------------------------------------------------
    State                |    ME
-----------------------------------------------------
    Zip                  |    04106-5900
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    207-828-0361
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225X00000X
-----------------------------------------------------
    Taxonomy Name        |    Occupational Therapist
-----------------------------------------------------
    License Number       |    OT3854
-----------------------------------------------------
    License Number State |    ME
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    225XP0200X
-----------------------------------------------------
    Taxonomy Name        |    Pediatric Occupational Therapist
-----------------------------------------------------
    License Number       |    OT3854
-----------------------------------------------------
    License Number State |    ME
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.