Provider Demographics
NPI:1609445501
Name:HOLBROOK, WHITNEY SANDOR (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:SANDOR
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 BULL RIVER BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-1554
Mailing Address - Country:US
Mailing Address - Phone:125-287-6283
Mailing Address - Fax:
Practice Address - Street 1:227 BULL RIVER BLUFF DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-1554
Practice Address - Country:US
Practice Address - Phone:252-876-2830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010682235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist