Individual
RANDY LEE WHITTLES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
502 N MARKET ST, CHAMPAIGN, IL 61820-3634
(217) 373-2428
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS01634
RI
Other
Enumeration date
12/30/2009
Last updated
07/21/2022
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