Provider Demographics
NPI:1962299826
Name:WHITEMON, KIARA SAVON
Entity type:Individual
Prefix:
First Name:KIARA
Middle Name:SAVON
Last Name:WHITEMON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6770 COUNTY ROAD 3918
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75752-4168
Mailing Address - Country:US
Mailing Address - Phone:903-288-0976
Mailing Address - Fax:
Practice Address - Street 1:6770 COUNTY ROAD 3918
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75752-4168
Practice Address - Country:US
Practice Address - Phone:903-288-0976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician