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NPI Code Detail

MEDICARE: ANITARA WHITFIELD

MEDICARE:   ANITARA  WHITFIELD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1063230639
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANITARA WHITFIELD
Provider Business Mailing Address
First Line : 1315 NORTHWEST DR NW APT 1101
Second Line :
City : ATLANTA
State : GA
Zip : 30318-3817
Country : US
Telephone Number : 225-439-5810
Fax Number :
Provider Business Practice Location Address
First Line : 1315 NORTHWEST DR NW APT 1101
Second Line :
City : ATLANTA
State : GA
Zip : 30318-3817
Country : US
Telephone Number : 225-439-5810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2024
Last Update Date : 10/02/2024

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Directions to “ ANITARA WHITFIELD ” Practice Location

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