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Individual
DYLAN KIERAN WHITLOW
Active
Individual
DYLAN KIERAN WHITLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
109366
CA
174H00000X
Health Educator
174H00000X
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174H00000X
HEALTH EDUCATOR
CA
01
—
17690948798
LICENSED CLINICAL SOCIAL WORKER
CA
Enumeration date
02/14/2019
Last updated
12/05/2022
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