Provider Demographics
NPI:1982615183
Name:WHITTARD, CATHERINE JOANN (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JOANN
Last Name:WHITTARD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BURNLEA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-5086
Mailing Address - Country:US
Mailing Address - Phone:703-737-8194
Mailing Address - Fax:
Practice Address - Street 1:906-A TRAILVIEW BLVD, SE,
Practice Address - Street 2:COUNTY OF LOUDOUN, VA - EARLY INTERVENTION
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175
Practice Address - Country:US
Practice Address - Phone:703-777-0561
Practice Address - Fax:703-737-8235
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist