Provider Demographics
NPI:1679276935
Name:WHITMIRE, EMMALEE ANN (LSWAIC)
Entity Type:Individual
Prefix:
First Name:EMMALEE
Middle Name:ANN
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:EMMETT
Other - Middle Name:ELIJAH
Other - Last Name:WHITMIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSWAIC
Mailing Address - Street 1:100 N HOWARD ST # 5269
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:206-249-7574
Mailing Address - Fax:
Practice Address - Street 1:100 N HOWARD ST # 5269
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-0508
Practice Address - Country:US
Practice Address - Phone:206-249-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC614028371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical