Provider Demographics
NPI:1467630426
Name:WHELIHAN, KATHLEEN ANN
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANN
Last Name:WHELIHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CUMMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01026-9649
Mailing Address - Country:US
Mailing Address - Phone:413-634-5611
Mailing Address - Fax:
Practice Address - Street 1:437 STAGE RD
Practice Address - Street 2:
Practice Address - City:CUMMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01026-9649
Practice Address - Country:US
Practice Address - Phone:413-634-5611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA280645174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA280645OtherDOE - TEACHER CERTIFICATI