Provider Demographics
NPI:1861218794
Name:CALVERT, EMILY K (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:CALVERT
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LANNING LN
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-4146
Mailing Address - Country:US
Mailing Address - Phone:573-458-0190
Mailing Address - Fax:
Practice Address - Street 1:402 LANNING LN
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4146
Practice Address - Country:US
Practice Address - Phone:573-458-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024027799235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist