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General NPI Number Information
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NPI Number | 1770364812
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Entity Type | Individual
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Provider Name | LAUREN WHITLOW MA
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Gender | Female
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 05/02/2024
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Provider Practice Location Address
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Address Line | 4602 MACCORKLE AVE SE
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City | CHARLESTON
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State | WV
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Zip | 25304-1848
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Country | US
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Telephone | 304-205-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 3518 W 25TH ST
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City | CLEVELAND
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State | OH
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Zip | 44109-1951
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Country | US
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Telephone | 216-741-2241
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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