Provider Demographics
NPI:1285300111
Name:COOTS, EMILY KATHRYN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHRYN
Last Name:COOTS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 IDYLWILD CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3608
Mailing Address - Country:US
Mailing Address - Phone:859-940-6810
Mailing Address - Fax:
Practice Address - Street 1:116 MERIDIAN WAY STE 8
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2876
Practice Address - Country:US
Practice Address - Phone:859-626-2107
Practice Address - Fax:859-985-9401
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY248467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist