Doctor Name: | AL WHITTEN |
NPI Number: | 1265695654 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHRT-C |
License Number: | |
Business Practice Address: | 8 Wesleyan St Fort Fairfield, ME - 047422010 |
Business Phone Number: | 2074739285 |
Business Fax Number: | 2074739403 |
Mailing Address: | 8 Wesleyan St, FORT FAIRFIELD |
State: | ME |
Postal Code: | 047422010 |
Phone Number: | 2074739285 |
Fax Number: | 2074739403 |
NPI Enumeration Date: | 07/07/2008 |
NPI Last Update Date: | 07/07/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |