Provider Demographics
NPI:1578951828
Name:WHITLEY, PAULA
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:W
Other - Last Name:STEEGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3939
Mailing Address - Country:US
Mailing Address - Phone:757-274-9727
Mailing Address - Fax:
Practice Address - Street 1:1501 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23325-3939
Practice Address - Country:US
Practice Address - Phone:757-274-9727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002597235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist