Provider Demographics
NPI:1538587993
Name:HAMER, WHITLEY
Entity type:Individual
Prefix:
First Name:WHITLEY
Middle Name:
Last Name:HAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITLEY
Other - Middle Name:D
Other - Last Name:HAMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1706 PRIVATE ROAD 3097
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-7504
Mailing Address - Country:US
Mailing Address - Phone:662-544-0410
Mailing Address - Fax:
Practice Address - Street 1:1706 PRIVATE ROAD 3097
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-7504
Practice Address - Country:US
Practice Address - Phone:662-544-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3813235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist