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General NPI Number Information
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NPI Number | 1114227121
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Entity Type | Individual
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Provider Name | JOSEPHINE WHITLEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 508 DEEP EDDY AVE.
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City | AUSTIN
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State | TX
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Zip | 78703-4555
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Country | US
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Telephone | 512-469-0765
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Fax | 512-469-0889
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Provider Business Mailing Address
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Address Line | 508 DEEP EDDY AVE.
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City | AUSTIN
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State | TX
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Zip | 78703-4555
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Country | US
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Telephone | 512-469-0765
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Fax | 512-469-0889
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 2-3425
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License Number State | TX
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