Provider Demographics
NPI:1821431297
Name:SHOTT, WHITNEY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SHOTT
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 1:3801 MAIN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-5297
Mailing Address - Country:US
Mailing Address - Phone:479-856-6400
Mailing Address - Fax:479-856-6623
Practice Address - Street 1:3801 MAIN DR
Practice Address - Street 2:SUITE B
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5297
Practice Address - Country:US
Practice Address - Phone:479-856-6400
Practice Address - Fax:479-856-6623
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist