Provider Demographics
NPI:1801199930
Name:WHISLER, VICRORIA ANN (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:VICRORIA
Middle Name:ANN
Last Name:WHISLER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44214 228TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-7455
Mailing Address - Country:US
Mailing Address - Phone:253-350-3355
Mailing Address - Fax:
Practice Address - Street 1:1724 COLE ST
Practice Address - Street 2:SUITE 11A
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3554
Practice Address - Country:US
Practice Address - Phone:253-350-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-12
Last Update Date:2010-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002463106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist