Provider Demographics
NPI:1073043899
Name:HOLMES, EMILY ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:PRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19021 120TH AVE NE STE 102
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-9511
Mailing Address - Country:US
Mailing Address - Phone:425-486-7710
Mailing Address - Fax:425-483-6059
Practice Address - Street 1:19021 120TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-9511
Practice Address - Country:US
Practice Address - Phone:425-486-7710
Practice Address - Fax:425-483-6059
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006317A235Z00000X
WALL61342648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist