Provider Demographics
NPI:1114763711
Name:WHITTENBERGER, CAROLINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:WHITTENBERGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3929 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5236
Mailing Address - Country:US
Mailing Address - Phone:443-878-3270
Mailing Address - Fax:
Practice Address - Street 1:1501 BLENHIEM FARM LN
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-2047
Practice Address - Country:US
Practice Address - Phone:410-939-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist