Provider Demographics
NPI:1124709738
Name:TONY, EMILY SUZANNE (OTR)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:SUZANNE
Last Name:TONY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:SUZANNE
Other - Last Name:HUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:500 GREENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5718
Mailing Address - Country:US
Mailing Address - Phone:817-991-8725
Mailing Address - Fax:
Practice Address - Street 1:3401 CUSTER RD STE 154
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7587
Practice Address - Country:US
Practice Address - Phone:972-800-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111012225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics