Provider Demographics
NPI:1033666235
Name:KATELYN WHYTE
Entity Type:Organization
Organization Name:KATELYN WHYTE
Other - Org Name:KATELYN WHYTE SPEECH THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHYTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:610-905-5946
Mailing Address - Street 1:8390 CHAMPIONS GATE BLVD
Mailing Address - Street 2:215
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8310
Mailing Address - Country:US
Mailing Address - Phone:407-479-2015
Mailing Address - Fax:
Practice Address - Street 1:215 TIMOTHY TRL S
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8475
Practice Address - Country:US
Practice Address - Phone:610-905-5946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty