Provider Demographics
NPI:1073862025
Name:SCHAEFER, EMILY CLAIRE (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:CLAIRE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11279 W. GRIER RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653
Mailing Address - Country:US
Mailing Address - Phone:520-682-4738
Mailing Address - Fax:
Practice Address - Street 1:11279 W. GRIER RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85653
Practice Address - Country:US
Practice Address - Phone:520-682-4738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7889235Z00000X
AZTSLP7889235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist