Provider Demographics
NPI:1215996707
Name:QUADE, EMILY K (MA,CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:K
Last Name:QUADE
Suffix:
Gender:F
Credentials:MA,CCC,SLP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:603 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2049
Mailing Address - Country:US
Mailing Address - Phone:330-723-2035
Mailing Address - Fax:
Practice Address - Street 1:1929A E ROYALTON RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2809
Practice Address - Country:US
Practice Address - Phone:440-838-0990
Practice Address - Fax:440-838-8440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-4888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH314380051026OtherCARESOURCE INS. CO.
OH0849916Medicaid