Provider Demographics
NPI:1154732519
Name:WHIPPLE, KATIE GRIFFIN (MUSIC THERAPIST)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:GRIFFIN
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:MUSIC THERAPIST
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5050 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3995
Mailing Address - Country:US
Mailing Address - Phone:800-555-9073
Mailing Address - Fax:972-367-3452
Practice Address - Street 1:120 W CAMPUS DR
Practice Address - Street 2:BOX 091
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-1990
Practice Address - Country:US
Practice Address - Phone:478-445-5288
Practice Address - Fax:478-445-3142
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMUT000005225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist