Provider Demographics
NPI:1295619567
Name:HOESMAN, WHITLEY BLAYRE
Entity type:Individual
Prefix:
First Name:WHITLEY
Middle Name:BLAYRE
Last Name:HOESMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 CANA CT
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-9467
Mailing Address - Country:US
Mailing Address - Phone:812-281-1059
Mailing Address - Fax:
Practice Address - Street 1:4803 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4565
Practice Address - Country:US
Practice Address - Phone:812-269-5038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician