Provider Demographics
NPI:1861538142
Name:MCCALLEY-WHITTERS, MONA (PHD)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:MCCALLEY-WHITTERS
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:PO BOX 2237
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-2237
Mailing Address - Country:US
Mailing Address - Phone:319-393-0004
Mailing Address - Fax:319-393-0900
Practice Address - Street 1:3705 RIVER RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7596
Practice Address - Country:US
Practice Address - Phone:319-393-0004
Practice Address - Fax:319-393-0900
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00685103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist