Provider Demographics
NPI:1174833446
Name:FOREMAN, EMILY PARK (AUD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:PARK
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:425 PATTERSON RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506
Mailing Address - Country:US
Mailing Address - Phone:970-255-3544
Mailing Address - Fax:303-242-9092
Practice Address - Street 1:425 PATTERSON RD
Practice Address - Street 2:SUITE 503
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-255-3544
Practice Address - Fax:303-242-9092
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12103452231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist