Provider Demographics
NPI:1508678160
Name:HENDRICKSON, WHITNEY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:HENDRICKSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 DAWSON RD
Mailing Address - Street 2:
Mailing Address - City:WHITE BLUFF
Mailing Address - State:TN
Mailing Address - Zip Code:37187-4206
Mailing Address - Country:US
Mailing Address - Phone:417-592-8676
Mailing Address - Fax:
Practice Address - Street 1:1008 DAWSON RD
Practice Address - Street 2:
Practice Address - City:WHITE BLUFF
Practice Address - State:TN
Practice Address - Zip Code:37187-4206
Practice Address - Country:US
Practice Address - Phone:417-592-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4724235Z00000X
TN7672235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist