Doctor Name: | DR. ALAN J. WHITLOCK |
NPI Number: | 1174533525 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PSY 340 |
Business Practice Address: | 814 S Washington St Moscow, ID - 838433049 |
Business Phone Number: | 2088834026 |
Business Fax Number: | |
Mailing Address: | 814 S Washington St, MOSCOW |
State: | ID |
Postal Code: | 838433049 |
Phone Number: | 2088834026 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PSY 340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |