Individual
JARED ROBERT WHITTINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
600 WYOMING BLVD NE, ALBUQUERQUE, NM 87123-1038
Mailing address
600 WYOMING BLVD NE, ALBUQUERQUE, NM 87123-1038
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4792
OK
Other
Enumeration date
09/29/2017
Last updated
09/29/2017
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