Provider Demographics
NPI:1538049556
Name:FOGARTY, EMILY MARIE (MA, SLP-CCC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:FOGARTY
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7847 COLE WOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-7783
Mailing Address - Country:US
Mailing Address - Phone:219-484-0468
Mailing Address - Fax:
Practice Address - Street 1:321 N LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-3641
Practice Address - Country:US
Practice Address - Phone:317-226-4258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22008662A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist