Provider Demographics
NPI:1174975064
Name:WHITTLE, KATHRYN GROVES (AUD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:GROVES
Last Name:WHITTLE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:KUYKENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 SUMMER LEE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032
Mailing Address - Country:US
Mailing Address - Phone:972-771-5443
Mailing Address - Fax:972-771-5444
Practice Address - Street 1:763 E US HIGHWAY 80
Practice Address - Street 2:SUITE 230
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-8633
Practice Address - Country:US
Practice Address - Phone:972-771-5443
Practice Address - Fax:972-771-5444
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80883231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist