Provider Demographics
NPI:1720489636
Name:DITTMAN, WHITNEY MCKENNA (SLP)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:MCKENNA
Last Name:DITTMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:WHITNEY
Other - Middle Name:MCKENNA
Other - Last Name:DITTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SLP
Mailing Address - Street 1:20912 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-1782
Mailing Address - Country:US
Mailing Address - Phone:713-204-5021
Mailing Address - Fax:
Practice Address - Street 1:20912 CEDAR LN
Practice Address - Street 2:
Practice Address - City:SPICEWOOD
Practice Address - State:TX
Practice Address - Zip Code:78669-1782
Practice Address - Country:US
Practice Address - Phone:713-204-5021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty