Provider Demographics
NPI:1316500978
Name:WHALEY, AMELIA JANE (PT, DPT)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:JANE
Last Name:WHALEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:JANE
Other - Last Name:TARLTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:38552 SUSSEX HWY UNIT 102
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-3596
Mailing Address - Country:US
Mailing Address - Phone:302-466-3230
Mailing Address - Fax:302-466-3231
Practice Address - Street 1:38552 SUSSEX HWY UNIT 102
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-3596
Practice Address - Country:US
Practice Address - Phone:302-466-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0014247225100000X
MD27774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist