Provider Demographics
NPI:1548975022
Name:VERBA, WHITNEY JAY
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JAY
Last Name:VERBA
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 1:4095 N POINT CIR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-3840
Mailing Address - Country:US
Mailing Address - Phone:334-806-9381
Mailing Address - Fax:
Practice Address - Street 1:4095 N POINT CIR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-3840
Practice Address - Country:US
Practice Address - Phone:334-806-9381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE866507106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician