Individual
MS. JANUARY RAE WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADAC II
Contact information
Practice address
508 JACKSON ST # 102, JASPER, IN 47546-3128
(812) 817-0760
Mailing address
1317 3RD ST, BEDFORD, IN 47421-1805
(812) 797-9711
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C2-51294
IN
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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