Provider Demographics
NPI:1396424107
Name:EMERY, ERICA LYN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LYN
Last Name:EMERY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-5614
Mailing Address - Country:US
Mailing Address - Phone:561-252-0898
Mailing Address - Fax:
Practice Address - Street 1:626 GROVE ST
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33461-5614
Practice Address - Country:US
Practice Address - Phone:561-252-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist