Provider Demographics
NPI:1467716217
Name:WHITMAN, MONICA LEA
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:LEA
Last Name:WHITMAN
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:PO BOX 3851
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-3851
Mailing Address - Country:US
Mailing Address - Phone:405-359-7132
Mailing Address - Fax:
Practice Address - Street 1:501 W 15TH ST
Practice Address - Street 2:APT. 67
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3643
Practice Address - Country:US
Practice Address - Phone:405-359-7132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst