Individual
MISTY DAYLE WHALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1081 OAK ST STE 3, PITTSTON, PA 18640-3716
(888) 726-4774
Mailing address
9 BANKS AVE, MCADOO, PA 18237-2508
(888) 726-4774
(570) 362-5112
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
PA
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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