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NPI Code Detail

MEDICARE: LILY WHITE

MEDICARE: LILY WHITE
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
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1558028357
Entity Type Code : Individual
Provider Name (Legal Business Name) : LILY WHITE
Provider Business Mailing Address
First Line : 209 ROOT RD
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-9801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 209 ROOT RD
Second Line :
City : WESTFIELD
State : MA
Zip : 01085-9801
Country : US
Telephone Number : 413-568-3942
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2021
Last Update Date : 11/29/2021

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Directions to “ LILY WHITE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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