Angie Lynn Whitis, SLP
Individual provider Active NPI Speech-Language Pathologist · Boaz, KY
NPI 1245674530 · NPPES record last updated Apr 17, 2013
Key facts
- NPI
- 1245674530
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2403 (KY)
- Practice address
- 784 Whitis Rd
Boaz, KY 42027-8219 - Phone
- (270) 658-3727
- NPI assigned
- Apr 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2403 | KY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2403 | KY | Yes |
Addresses
Primary practice location
784 Whitis Rd
Boaz, KY 42027-8219
Mailing address
784 Whitis Rd
Boaz, KY 42027-8219
Phone (270) 658-3727
Other providers in Boaz, KY
- Hollie Elizabeth Brookshire
- Melissa Burnett
- Stephanie T Ingram
- Lisa McCoy Miller Arnp PLLC
- Marley K Snow
All providers in Boaz, KY · Speech-Language Pathologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.