Individual
DR. ALAN J. WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 883-4026
Mailing address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 883-4026
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY 340
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017398
REGENCE BLUE SHIELD OF ID
ID
01
—
N3405
BLUE CROSS OF IDAHO
ID
Enumeration date
08/08/2006
Last updated
07/08/2007
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