Individual
MRS. MILDRED R WHITLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11517 KANIS RD, LITTLE ROCK, AR 72211-3724
(501) 993-8707
(501) 223-8075
Mailing address
13817 ABINGER CT, LITTLE ROCK, AR 72212-3736
(501) 219-2202
(501) 223-8075
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PT 2087
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168152721
—
AR
Enumeration date
07/30/2008
Last updated
07/30/2008
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