Provider Demographics
NPI:1417511692
Name:EMERALD CITY THERAPIES, PLLC
Entity type:Organization
Organization Name:EMERALD CITY THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:214-679-0235
Mailing Address - Street 1:1002 LEGACY RANCH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1293
Mailing Address - Country:US
Mailing Address - Phone:214-980-1397
Mailing Address - Fax:469-340-4074
Practice Address - Street 1:1002 LEGACY RANCH RD STE 104
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1293
Practice Address - Country:US
Practice Address - Phone:214-980-1397
Practice Address - Fax:469-340-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty