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Individual

BONNIE L WHIPPLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
905 US RTE 522, EVANGELICAL MEDICAL BUILDING, SELINSGROVE, PA 17870
(570) 374-0496
(570) 374-3295
Mailing address
10 BURGESS AVE, SELINSGROVE, PA 17870-9403
(570) 374-0496

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-006902L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001411997
HIGHMARK BC/BS
PA
05
0018933940003
PA
01
50009445
CAPITAL BLUE CROSS
PA
Enumeration date
02/22/2006
Last updated
05/24/2010
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