Provider Demographics
NPI:1588969067
Name:EMMERT, LARCY JOY (SLP)
Entity type:Individual
Prefix:MRS
First Name:LARCY
Middle Name:JOY
Last Name:EMMERT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S STATE ROAD 57
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-4373
Mailing Address - Country:US
Mailing Address - Phone:812-254-4516
Mailing Address - Fax:
Practice Address - Street 1:801 S STATE ROAD 57
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-4373
Practice Address - Country:US
Practice Address - Phone:812-254-4516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist