Provider Demographics
NPI:1811341274
Name:WHITAKER, EMILY P (SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:P
Last Name:WHITAKER
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 1:3031 W IH 10
Mailing Address - Street 2:ATTN: CREDENTIALING DEPARTMENT
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-5159
Mailing Address - Country:US
Mailing Address - Phone:210-261-1000
Mailing Address - Fax:210-731-8678
Practice Address - Street 1:5802 S PRESA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3506
Practice Address - Country:US
Practice Address - Phone:210-261-3300
Practice Address - Fax:210-532-6090
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110202235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist