Provider Demographics
NPI:1588890966
Name:MOONEY, EMILY (CCC SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MOONEY
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 1:4050 S 212TH CT
Mailing Address - Street 2:UNIT B
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98198-4237
Mailing Address - Country:US
Mailing Address - Phone:253-277-1222
Mailing Address - Fax:
Practice Address - Street 1:4050 S 212TH CT
Practice Address - Street 2:UNIT B
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98198-4237
Practice Address - Country:US
Practice Address - Phone:253-277-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-30
Last Update Date:2009-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL 00003378235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist