Tanicia Whiteside, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5202006157 Issued in MI

Practice address

13794 21 Mile Rd
Shelby Township, MI 48315-4854

Phone

(586) 532-2100

NPI assigned

Aug 15, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439596800000",
    "number": "1962878769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26427 CATHEDRAL",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391846",
            "telephone_number": "248-219-4758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13794 21 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154854",
            "telephone_number": "586-532-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "TANICIA",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-15",
        "last_updated": "2015-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202006157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne White, PA-C
• Ethan White, OTR/L
• Gabriella Alice White
• Sylvia White
• Whitney Renee White, FNP
• Melissa Whiting, BCBA, LBA
• Shayla Ann Whitt, M.ED., BCBA, LBA
• Whole Life Balance
• Elizabeth Ann Wilkins, DPT
• William G. Ziecina, D.D.S., P.C.

• Occupational Therapy Assistant in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Occupational Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.