Individual
LISA WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1092 W COMMUNITY WAY, SCOTTSBURG, IN 47170-7768
(812) 414-1520
(812) 752-5935
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 339-8109
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34009293A
IN
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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