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Individual

DR. MICHAEL ROBERT WHITEHEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., LMFT

Contact information

Practice address
762 FALLS AVE, TWIN FALLS, ID 83301-3316
(208) 258-7681
Mailing address
762 FALLS AVE, TWIN FALLS, ID 83301-3316
(208) 258-7681
(208) 907-0874

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
4101006429
MI
106H00000X
Marriage & Family Therapist
8324338-3902
UT
106H00000X
Marriage & Family Therapist
LF60462315
WA
106H00000X
Marriage & Family Therapist
Primary
LMFT-7120
ID

Other

Enumeration date
05/01/2012
Last updated
04/24/2025
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