Healthcare Provider Details

I. General information

NPI: 1043139041
Provider Name (Legal Business Name): WHITNEY DURBIN M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MUNGER LN
HANNIBAL MO
63401-2361
US

IV. Provider business mailing address

207 N WEST ST
MADISON MO
65263-1091
US

V. Phone/Fax

Practice location:
  • Phone: 573-248-2627
  • Fax:
Mailing address:
  • Phone: 636-887-6456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2016021036
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: