Provider Demographics
NPI:1912418476
Name:WHIPPLE, KATHY ANN (PHD)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATHY
Other - Middle Name:MARTINDALE
Other - Last Name:WHIPPLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1405 KEMPNER PARK
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:TX
Mailing Address - Zip Code:76706-5665
Mailing Address - Country:US
Mailing Address - Phone:254-717-2567
Mailing Address - Fax:
Practice Address - Street 1:2100 GORMAN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76707-2804
Practice Address - Country:US
Practice Address - Phone:254-717-2567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13794235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist