Provider Demographics
NPI:1053095018
Name:WHITELAW, KRISTIN LEE (PHD, CHT REV)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:LEE
Last Name:WHITELAW
Suffix:
Gender:F
Credentials:PHD, CHT REV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 S PARKSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2583
Mailing Address - Country:US
Mailing Address - Phone:310-760-2244
Mailing Address - Fax:
Practice Address - Street 1:1367 S PARKSTONE CT
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2583
Practice Address - Country:US
Practice Address - Phone:310-760-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral