Individual
BRIAN KEITH WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
601 W 2ND ST, SUITE 10, ROSWELL, NM 88201-4670
(575) 623-9322
(575) 627-6339
Mailing address
601 W 2ND ST, SUITE 10, ROSWELL, NM 88201-4670
(575) 623-9322
(575) 627-6339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
0966
NM
103TH0100X
Health Service Psychologist
Primary
0966
NM
Other
Enumeration date
01/31/2008
Last updated
04/23/2008
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