Individual
KELLY MARIE WHALING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
12466836-2501
UT
103TC0700X
Clinical Psychologist
12466836-2504
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2017
Last updated
07/27/2022
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