Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2568-057 | WI |
Y | 103TC0700X | Clinical Psychologist | 2568-057 | WI |
NPI | 1003865569 |
---|---|
Provider Name | Dr. Aaron Thomas Scott Whitney |
First Address | Platteville, WI 53818-1932 |
Second Address | Platteville, WI 53818-3839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
39757000 | (05) | WI |