Provider Demographics
NPI:1992953400
Name:SMITH, WHITNEY M
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:M
Last Name:SMITH
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 1:16359 SUSSEX HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19933-2966
Mailing Address - Country:US
Mailing Address - Phone:302-337-7990
Mailing Address - Fax:
Practice Address - Street 1:16359 SUSSEX HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-2966
Practice Address - Country:US
Practice Address - Phone:302-337-7990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0001076235500000X
235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE235500000XMedicaid