Individual
DONALD MAURICE WHITLEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1598 DELPHIC WAY, SUITE A-1, POCATELLO, ID 83201-2285
(208) 233-4900
(208) 233-4373
Mailing address
1598 DELPHIC WAY, SUITE A-1, POCATELLO, ID 83201-2285
(208) 233-4900
(208) 233-4373
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1804
GA
103TC0700X
Clinical Psychologist
2689
FL
103TC0700X
Clinical Psychologist
4839092-2501
UT
103TC0700X
Clinical Psychologist
Primary
PSY 418
ID
Other
Enumeration date
08/08/2006
Last updated
07/08/2007
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