Individual
HEATHER WHALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
204 RESOURCE LN, WINDER, GA 30680-8361
(678) 963-0694
(888) 547-4008
Mailing address
204 RESOURCE LN, WINDER, GA 30680-8361
(678) 963-0694
(888) 547-4008
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005369
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336394641-A
—
GA
Enumeration date
11/05/2006
Last updated
03/29/2011
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