Provider Demographics
NPI:1861764136
Name:WHALEN, JOSEPHINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:
Last Name:WHALEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8087 NW 128TH LN
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4902
Mailing Address - Country:US
Mailing Address - Phone:561-400-9312
Mailing Address - Fax:561-482-2690
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-400-9312
Practice Address - Fax:561-482-2690
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8404103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent