Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | 1-03-1463 | CA |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY19282 | CA |
NPI | 1053692046 |
---|---|
Provider Name | Dr. Christina Whalen |
First Address | Phoenix, AZ 85006-4103 |
Second Address | Phoenix, AZ 85006-4103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2011 |
Last Update Date | 13/06/2012 |