Provider Demographics
NPI:1255610549
Name:WHITFILL, GAYLA ANN (SLP)
Entity type:Individual
Prefix:
First Name:GAYLA
Middle Name:ANN
Last Name:WHITFILL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 JOSEPHINE ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-3519
Mailing Address - Country:US
Mailing Address - Phone:806-777-4346
Mailing Address - Fax:325-236-6112
Practice Address - Street 1:1503 JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-3519
Practice Address - Country:US
Practice Address - Phone:325-236-6821
Practice Address - Fax:325-236-6112
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist