MEDICARE: WHITNEY WINGARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1376200360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY WINGARD

Provider Business Mailing Address
First Line	:	2145 MARIS WAY
Second Line	:
City	:	MONROE
State	:	GA
Zip	:	30655-8328
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1559 JANMAR RD
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-5606
Country	:	US
Telephone Number	:	770-336-7373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2021
Last Update Date	:	03/15/2026

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Directions to “ WHITNEY WINGARD ” Practice Location

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