Provider Demographics
NPI:1235371055
Name:WHITSETT, CAMILLE (MED)
Entity Type:Individual
Prefix:MISS
First Name:CAMILLE
Middle Name:
Last Name:WHITSETT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12312
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-0312
Mailing Address - Country:US
Mailing Address - Phone:215-626-8466
Mailing Address - Fax:215-224-6772
Practice Address - Street 1:918 E HORTTER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-3604
Practice Address - Country:US
Practice Address - Phone:215-626-8466
Practice Address - Fax:215-224-6772
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health