Provider Demographics
NPI:1194974592
Name:BICKING, EMILY ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:BICKING
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:WEYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 TYLER RD STE Q1
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-3360
Mailing Address - Country:US
Mailing Address - Phone:630-444-0077
Mailing Address - Fax:
Practice Address - Street 1:525 TYLER RD STE Q1
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-3360
Practice Address - Country:US
Practice Address - Phone:630-444-0077
Practice Address - Fax:630-444-0078
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
IL146009967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist