Provider Information for 1588178974
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WHITNEY LYNETTE RACE LPC
Sex: Female
NPI: 1588178974
Last Updated: 2024-11-19
Certification Date: 2024-11-19
Certification Date: 2024-11-19
Details
| Name | Value | ||||||||
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| NPI | 1588178974 | ||||||||
| Enumeration Date | 2017-11-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 110 CAMPUS DR BRADFORD, PA 16701-1982 United States Phone: 814-362-6535 | Fax:814-817-2115 | ||||||||
| Primary Practice Address | 110 CAMPUS DR BRADFORD, PA 16701-1982 United States Phone: 814-362-6535 | Fax:814-817-2115 | ||||||||
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