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General NPI Number Information
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NPI Number | 1841019726
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Entity Type | Individual
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Provider Name | GERALDA A WHITTEMORE
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Gender | Female
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 302 E QUEEN ISABELLA STE E
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City | PORT ISABEL
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State | TX
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Zip | 78578-2407
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Country | US
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Telephone | 956-579-4002
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Fax |
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Provider Business Mailing Address
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Address Line | 226 W HOUSTON ST APT 212
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City | PORT ISABEL
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State | TX
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Zip | 78578-2948
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Country | US
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Telephone | 956-579-4002
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 90308
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License Number State | TX
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