Provider Demographics
NPI:1689073959
Name:WHALEY, EANAH (PHD)
Entity Type:Individual
Prefix:
First Name:EANAH
Middle Name:
Last Name:WHALEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 POOLE PLZ
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19074-1117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 SIGNER BLVD BLDG 554
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818
Practice Address - Country:US
Practice Address - Phone:202-767-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005229103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical