Provider Demographics
NPI:1558138404
Name:WHITING, EMILY NICOLE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NICOLE
Last Name:WHITING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:LOUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1252 HAZELNUT RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6253
Mailing Address - Country:US
Mailing Address - Phone:651-239-7881
Mailing Address - Fax:
Practice Address - Street 1:2300 GALLBERRY LN
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0161
Practice Address - Country:US
Practice Address - Phone:704-649-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0006079235Z00000X
NC30004396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist