Provider Demographics
NPI:1093072001
Name:TODD, WHITNEY (MED, CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:TODD
Suffix:
Gender:F
Credentials:MED, CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 ALBERTA CT
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-5924
Mailing Address - Country:US
Mailing Address - Phone:919-302-2206
Mailing Address - Fax:
Practice Address - Street 1:716 ALBERTA CT
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-5924
Practice Address - Country:US
Practice Address - Phone:919-302-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2012-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9895235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist