Healthcare Provider Details

I. General information

NPI: 1669101838
Provider Name (Legal Business Name): WHITNEY ELONA WHITE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7830 PINE FOREST RD BLDG A
PENSACOLA FL
32526-8782
US

IV. Provider business mailing address

208 W DETROIT BLVD
PENSACOLA FL
32534-3706
US

V. Phone/Fax

Practice location:
  • Phone: 850-741-6715
  • Fax: 850-204-0489
Mailing address:
  • Phone: 256-226-1866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: