Provider Demographics
NPI:1144767567
Name:BECKLEY, EMILY (SLP)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:BECKLEY
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-4607
Mailing Address - Country:US
Mailing Address - Phone:304-822-4561
Mailing Address - Fax:304-822-4951
Practice Address - Street 1:363 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-4607
Practice Address - Country:US
Practice Address - Phone:304-822-4561
Practice Address - Fax:304-822-4951
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist