Provider Demographics
NPI:1588901664
Name:WHITMARSH, ERNEST LEE JR (PHD)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:LEE
Last Name:WHITMARSH
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ROYAL OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-6581
Mailing Address - Country:US
Mailing Address - Phone:770-262-1743
Mailing Address - Fax:
Practice Address - Street 1:120 ROYAL OAKS DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-6581
Practice Address - Country:US
Practice Address - Phone:770-262-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst