Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | CC01515 | MN |
N | 101YP1600X | Pastoral Counselor | E0008095 | OH |
N | 101YP2500X | Professional Counselor | E0008095 | OH |
NPI | 1205970761 |
---|---|
Provider Name | Holly S Whitaker |
First Address | Naples, FL 34108-3201 |
Second Address | Saint Paul, MN 55108-5298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2007 |
Last Update Date | 05/11/2020 |