Individual
MR. JOSEPH WHITWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
17505 N 79TH AVE, SUITE 213, GLENDALE, AZ 85308-8725
(623) 800-7980
Mailing address
5152 W WIKIEUP LN, GLENDALE, AZ 85308-5060
(907) 242-5018
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAC-15674
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-15674
AZ
101YM0800X
Mental Health Counselor
LAC-15674
AZ
102L00000X
Psychoanalyst
Primary
LAC-15674
AZ
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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