Individual
ALTHEA WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
804 N WOODLAND BLVD, DELAND, FL 32720-2709
(386) 334-8942
(986) 943-8823
Mailing address
804 N WOODLAND BLVD, DELAND, FL 32720-2709
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07052500
—
FL
Enumeration date
10/07/2014
Last updated
10/07/2014
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