Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS018728 | PA |
Y | 103T00000X | Psychologist | PS018728 | PA |
N | 103TS0200X | School Psychologist |
NPI | 1023607249 |
---|---|
Provider Name | James Scott Whitaker |
First Address | Hanover, PA 17331-1142 |
Second Address | York, PA 17402-3863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2021 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PS018728 | LICENSE NUMBER (01) | PA |