Provider Demographics
NPI:1801929179
Name:WHALEY, ANN MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MARIE
Last Name:WHALEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8504 ROYSTER RUN
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7830
Mailing Address - Country:US
Mailing Address - Phone:804-687-4906
Mailing Address - Fax:
Practice Address - Street 1:8504 ROYSTER RUN
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-7830
Practice Address - Country:US
Practice Address - Phone:804-687-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist