Provider Demographics
NPI:1346881190
Name:WHITING, ADRIAN TRIALON (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ADRIAN
Middle Name:TRIALON
Last Name:WHITING
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:TRIALON
Other - Last Name:MALBROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:8709 SW 66TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73169-6968
Mailing Address - Country:US
Mailing Address - Phone:405-837-7106
Mailing Address - Fax:
Practice Address - Street 1:8801 S OLIE AVE STE 5
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9362
Practice Address - Country:US
Practice Address - Phone:405-837-7106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4952235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist