Provider Demographics
NPI:1891486155
Name:JUSTICE, WHITNEY BROOKE
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:BROOKE
Last Name:JUSTICE
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 1:815 ENGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-5103
Mailing Address - Country:US
Mailing Address - Phone:423-545-3022
Mailing Address - Fax:
Practice Address - Street 1:815 ENGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37354-5103
Practice Address - Country:US
Practice Address - Phone:423-545-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN948237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist