Individual
JILL LYNNE WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2578
Mailing address
1481 W 10TH ST, INDIANAPOLIS, IN 46202-2803
(317) 988-2578
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33005257A
IN
1041C0700X
Clinical Social Worker
34009156A
IN
Other
Enumeration date
06/23/2020
Last updated
02/10/2021
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