Individual
MCKAYLA JOAN WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
434 RUTLAND RD, PLYMOUTH, ME 04969
(207) 229-5565
Mailing address
PO BOX 16, PLYMOUTH, ME 04969-0016
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
XL7029
ME
101YM0800X
Mental Health Counselor
Primary
XL7029
ME
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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