Provider Demographics
NPI:1477952786
Name:LEWIS, WHITNEY PAGE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:PAGE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:WHITNEY
Other - Middle Name:PAGE
Other - Last Name:RENTSCHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:218 W MCCABE ST
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:MO
Mailing Address - Zip Code:65757-8840
Mailing Address - Country:US
Mailing Address - Phone:417-736-7000
Mailing Address - Fax:
Practice Address - Street 1:218 W MCCABE ST
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:MO
Practice Address - Zip Code:65757-8840
Practice Address - Country:US
Practice Address - Phone:417-736-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014021333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist