Provider Demographics
NPI:1659388312
Name:WHALEY, GERALDINE O'CONNOR (PHD MFT)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:O'CONNOR
Last Name:WHALEY
Suffix:
Gender:F
Credentials:PHD MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 YUCCA DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336
Mailing Address - Country:US
Mailing Address - Phone:928-282-2790
Mailing Address - Fax:928-204-0835
Practice Address - Street 1:220 YUCCA DR
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336
Practice Address - Country:US
Practice Address - Phone:928-282-2790
Practice Address - Fax:928-204-0835
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT10232106H00000X
CAMFC33491106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist