Individual
MR. BARRY WHITEHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
121 OAKWOOD DR, WAKE FOREST, NC 27587-9757
(410) 726-1116
Mailing address
121 OAKWOOD DR, WAKE FOREST, NC 27587-9757
(410) 726-1116
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2238
NC
235Z00000X
Speech-Language Pathologist
656463
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2238
LICENSE
NC
01
—
656463
LICENSE
MD
Enumeration date
07/02/2007
Last updated
07/08/2007
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