Provider Demographics
NPI:1427847243
Name:MASLICH, EMMA JEAN
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:JEAN
Last Name:MASLICH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E 800 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-1757
Mailing Address - Country:US
Mailing Address - Phone:540-355-8108
Mailing Address - Fax:
Practice Address - Street 1:15 E 800 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-1757
Practice Address - Country:US
Practice Address - Phone:540-355-8108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer