Provider Demographics
NPI:1538905435
Name:WHITTEMORE, ELLA R
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:R
Last Name:WHITTEMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PINEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-5025
Mailing Address - Country:US
Mailing Address - Phone:603-305-1483
Mailing Address - Fax:
Practice Address - Street 1:18 PINEWOOD RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-5025
Practice Address - Country:US
Practice Address - Phone:603-305-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst