Individual
MS. HEATHER T WHITTALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1800 30TH ST STE 212, BOULDER, CO 80301-1087
(720) 591-4664
Mailing address
1800 30TH ST STE 212, BOULDER, CO 80301-1087
(720) 591-4664
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3829
CO
103TC2200X
Clinical Child & Adolescent Psychologist
3829
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022463
KAISER COMMERCIAL NUMBER
CO
05
—
79600573
—
CO
Enumeration date
08/27/2010
Last updated
12/26/2024
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