Provider Demographics
NPI:1265189690
Name:WHELIHAN, LEE
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:WHELIHAN
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 1:3250 STATE HIGHWAY 166
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:13320-3141
Mailing Address - Country:US
Mailing Address - Phone:518-231-8990
Mailing Address - Fax:
Practice Address - Street 1:3 CHENANGO RD
Practice Address - Street 2:
Practice Address - City:EDMESTON
Practice Address - State:NY
Practice Address - Zip Code:13335-2314
Practice Address - Country:US
Practice Address - Phone:607-965-8377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031637235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist