Provider Demographics
NPI:1548613565
Name:HAVINS, WHITNEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:HAVINS
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 1:160 COMMONWEALTH AVE
Mailing Address - Street 2:STE U-3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2707
Mailing Address - Country:US
Mailing Address - Phone:617-259-1895
Mailing Address - Fax:
Practice Address - Street 1:160 COMMONWEALTH AVE
Practice Address - Street 2:STE U-3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2707
Practice Address - Country:US
Practice Address - Phone:617-259-1895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist