Individual
RICHARD R WHITTLESEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4601 CORBETT DR, FORT COLLINS, CO 80528-9579
(970) 207-4800
(970) 207-4885
Mailing address
4601 CORBETT DR, FORT COLLINS, CO 80528-9579
(970) 207-4800
(970) 207-4885
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
00072
IA
103TC0700X
Clinical Psychologist
00194
IA
103TC0700X
Clinical Psychologist
Primary
PSY.0003103
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008243
—
IA
01
—
42660
WELLMARK HEALTH PLAN
IA
01
—
IA01A1
JOHN DEERE HEALTH PLAN
—
Enumeration date
10/06/2005
Last updated
04/13/2016
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