MEDICARE: TERRI MAE WILHOIT OTA

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
1	224Z00000X	Occupational Therapy Assistant	206925	TX

General Provider Information

NPI Number	:	1851255574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI MAE WILHOIT OTA

Provider Business Mailing Address
First Line	:	1701 SMALLWOOD DR
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601-3743
Country	:	US
Telephone Number	:	940-366-1724
Fax Number	:	940-366-1724

Provider Business Practice Location Address
First Line	:	1701 SMALLWOOD DR
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601-3743
Country	:	US
Telephone Number	:	940-366-1724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ TERRI MAE WILHOIT OTA” Practice Location

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