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Individual

KAYLEEN ARIANA WHITAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
511 E COLUMBUS AVE, SPRINGFIELD, MA 01105-2506
(413) 733-3488
(413) 732-5856
Mailing address
32 SAINT KOLBE DR APT D, HOLYOKE, MA 01040-6701
(413) 218-1657

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN98236
MA
167G00000X
Licensed Psychiatric Technician
LN98236
MA

Other

Enumeration date
05/07/2021
Last updated
05/07/2021
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