Individual
SAMUEL WARREN WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 BRIGHTON KNOLL CT, ACCOKEEK, MD 20607-2718
(202) 997-4631
Mailing address
104 BRIGHTON KNOLL CT, ACCOKEEK, MD 20607-2718
(202) 997-4631
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
965
DC
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
DC
Other
Enumeration date
03/09/2023
Last updated
08/21/2023
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