Provider Demographics
NPI:1295053007
Name:WHITING PEDIATRIC THERAPY SERVICES, LLC.
Entity type:Organization
Organization Name:WHITING PEDIATRIC THERAPY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CCC-SLP
Authorized Official - Phone:772-584-3888
Mailing Address - Street 1:1140 7TH CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5706
Mailing Address - Country:US
Mailing Address - Phone:772-584-3888
Mailing Address - Fax:772-584-3889
Practice Address - Street 1:1140 7TH CT
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5706
Practice Address - Country:US
Practice Address - Phone:772-584-3888
Practice Address - Fax:772-584-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884340600Medicaid
FL002176200Medicaid