Provider Demographics
NPI:1144579764
Name:FLORES, EMILY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:FLORES
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:LEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1595 S CALUMET RD
Mailing Address - Street 2:#1
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2388
Mailing Address - Country:US
Mailing Address - Phone:219-763-6858
Mailing Address - Fax:
Practice Address - Street 1:1595 S CALUMET RD
Practice Address - Street 2:#1
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-2388
Practice Address - Country:US
Practice Address - Phone:219-763-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP7826235Z00000X
IN22005921A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist