Provider Demographics
NPI:1063196426
Name:KILLOUGH, EMILY REIKO (CF-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:REIKO
Last Name:KILLOUGH
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 WILSHIRE WAY APT 5114
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-0066
Mailing Address - Country:US
Mailing Address - Phone:808-389-9523
Mailing Address - Fax:
Practice Address - Street 1:5236 W UNIVERSITY DR STE 3500
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-8122
Practice Address - Country:US
Practice Address - Phone:469-952-5082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121074235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist