Provider Demographics
NPI:1790047645
Name:DEAN, WHITNEY TALLEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:TALLEY
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 TURNMEYER DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-3358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 245
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2216
Practice Address - Country:US
Practice Address - Phone:205-942-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3312235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist