Provider Demographics
NPI:1962197780
Name:LANDRY, EMILY DIANE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:DIANE
Last Name:LANDRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 WOODRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-5703
Mailing Address - Country:US
Mailing Address - Phone:409-781-9942
Mailing Address - Fax:
Practice Address - Street 1:19411 MCKAY DR STE 300
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5713
Practice Address - Country:US
Practice Address - Phone:281-446-2680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist