| Doctor Name: | CONNIE R WHELAN |
| NPI Number: | 1114053998 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | S0417 |
| Business Practice Address: | 702 Highway 82 W Suite B Greenwood, MS - 389305069 |
| Business Phone Number: | 6624555010 |
| Business Fax Number: | 6624555468 |
| Mailing Address: | 1211 River Rd, GREENWOOD |
| State: | MS |
| Postal Code: | 389304028 |
| Phone Number: | 6624535066 |
| Fax Number: | 6624553524 |
| NPI Enumeration Date: | 02/26/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | S0417 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |