Provider Demographics
NPI:1770626277
Name:WHISLER, LANNA JANE (SLP)
Entity type:Individual
Prefix:MRS
First Name:LANNA
Middle Name:JANE
Last Name:WHISLER
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 1:11077 WILDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:MO
Mailing Address - Zip Code:65084-5020
Mailing Address - Country:US
Mailing Address - Phone:573-378-2119
Mailing Address - Fax:
Practice Address - Street 1:11077 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:MO
Practice Address - Zip Code:65084-5020
Practice Address - Country:US
Practice Address - Phone:573-378-2119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist