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General NPI Number Information
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NPI Number | 1346426434
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Entity Type | Individual
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Provider Name | TIM L WHETZEL LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 47 JUNIPER DR
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City | SHEPHERDSTOWN
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State | WV
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Zip | 25443-4192
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Country | US
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Telephone | 304-870-4543
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Fax | 888-366-1169
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Provider Business Mailing Address
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Address Line | 47 JUNIPER DR
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City | SHEPHERDSTOWN
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State | WV
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Zip | 25443-4192
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Country | US
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Telephone | 304-870-4543
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Fax | 888-366-1169
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12
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License Number State | WV
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