Provider Demographics
NPI:1043710528
Name:PERRY, EMILY BRIANN (MED CCC - SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BRIANN
Last Name:PERRY
Suffix:
Gender:F
Credentials:MED CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7104 ASH CREEK HTS APT 103
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3677
Mailing Address - Country:US
Mailing Address - Phone:912-312-1945
Mailing Address - Fax:
Practice Address - Street 1:6825 SILVER PONDS HTS STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908-4782
Practice Address - Country:US
Practice Address - Phone:719-377-2523
Practice Address - Fax:719-355-8452
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist