Individual
JENNIFER WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2631 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(812) 855-3605
Mailing address
2631 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-9059
(128) 855-3605
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006056A
IN
Other
Enumeration date
09/01/2016
Last updated
03/16/2021
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