Provider Demographics
NPI:1093843518
Name:WHITING, EMILY M (PHD,CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:M
Last Name:WHITING
Suffix:
Gender:F
Credentials:PHD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 7TH CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5706
Mailing Address - Country:US
Mailing Address - Phone:772-584-3888
Mailing Address - Fax:772-584-3889
Practice Address - Street 1:1140 7TH CT
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5706
Practice Address - Country:US
Practice Address - Phone:772-584-3888
Practice Address - Fax:772-584-3889
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884340600Medicaid