Provider Demographics
NPI:1245446996
Name:KING WHITAKER, EUNICE B (BA)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:B
Last Name:KING WHITAKER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:B
Other - Last Name:KING WIMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27 ALICE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01109
Mailing Address - Country:US
Mailing Address - Phone:413-297-3930
Mailing Address - Fax:
Practice Address - Street 1:227 MILL ST
Practice Address - Street 2:PROVIDENCE BEHAVIORAL HEALTH HOSPITAL
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108
Practice Address - Country:US
Practice Address - Phone:413-747-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor