Provider Demographics
NPI:1619261815
Name:WILHITE, DAWN MACHELLE (EDS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:MACHELLE
Last Name:WILHITE
Suffix:
Gender:F
Credentials:EDS, CCC-SLP
Other - Prefix:MISS
Other - First Name:DAWN
Other - Middle Name:MACHELLE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDS, CCC-SLP
Mailing Address - Street 1:PO BOX 1998
Mailing Address - Street 2:
Mailing Address - City:ROCKY FACE
Mailing Address - State:GA
Mailing Address - Zip Code:30740-1998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:170 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:ROCKY FACE
Practice Address - State:GA
Practice Address - Zip Code:30740-9430
Practice Address - Country:US
Practice Address - Phone:706-271-7681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist