Provider Demographics
NPI:1558590810
Name:PATRICK, WHITNEY PAIGE (SLP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:PAIGE
Last Name:PATRICK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:PAIGE
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPT 888182
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37995-8182
Mailing Address - Country:US
Mailing Address - Phone:800-355-3565
Mailing Address - Fax:423-714-2355
Practice Address - Street 1:DEPT 888182
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37995-8182
Practice Address - Country:US
Practice Address - Phone:800-355-3565
Practice Address - Fax:423-714-2355
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP2284235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist