Provider Demographics
NPI:1457464083
Name:WHITTAKER, DAVID KENT (MA COUNSELING)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:KENT
Last Name:WHITTAKER
Suffix:
Gender:M
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8034 DEMOCRACY CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6138
Mailing Address - Country:US
Mailing Address - Phone:281-923-8808
Mailing Address - Fax:800-319-8691
Practice Address - Street 1:16757 SQUYRES RD STE 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7294
Practice Address - Country:US
Practice Address - Phone:281-923-8808
Practice Address - Fax:800-319-8691
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001012-040644106H00000X
TX03521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional