Provider Demographics
NPI:1609441773
Name:WHITEHEAD, AUBREY (MS)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4631 N MOUNTAIN GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-8487
Mailing Address - Country:US
Mailing Address - Phone:479-430-8860
Mailing Address - Fax:
Practice Address - Street 1:2221 E POINTER TRL
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2336
Practice Address - Country:US
Practice Address - Phone:479-474-7942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist