Provider Demographics
NPI:1083470652
Name:MILLER, EMILY (SLPA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:LOUISIANA
Mailing Address - State:MO
Mailing Address - Zip Code:63353-1814
Mailing Address - Country:US
Mailing Address - Phone:573-975-9661
Mailing Address - Fax:
Practice Address - Street 1:28176 HIGHWAY WW
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63336-2637
Practice Address - Country:US
Practice Address - Phone:573-485-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200095752355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant