Provider Demographics
NPI:1447945548
Name:CORRAL-WHITFORD, MAKAYA ANE (OTR/L)
Entity type:Individual
Prefix:
First Name:MAKAYA
Middle Name:ANE
Last Name:CORRAL-WHITFORD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W MILWAUKEE ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2916
Mailing Address - Country:US
Mailing Address - Phone:608-576-0662
Mailing Address - Fax:
Practice Address - Street 1:200 W MILWAUKEE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2916
Practice Address - Country:US
Practice Address - Phone:608-576-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist