Individual
WILLIAM WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAS, BA, M.ED.
Contact information
Practice address
1115 E SANGER ST, PHILADELPHIA, PA 19124-1130
(267) 461-1813
Mailing address
1115 E SANGER ST, PHILADELPHIA, PA 19124-1130
(267) 461-1813
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
PA
174400000X
Specialist
—
PA
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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