Provider Demographics
NPI:1245752450
Name:MCDANIEL, EMMA JANE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:JANE
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7506 VISTA CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-2639
Mailing Address - Country:US
Mailing Address - Phone:214-236-1129
Mailing Address - Fax:
Practice Address - Street 1:7506 VISTA CREEK LN
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-2639
Practice Address - Country:US
Practice Address - Phone:214-236-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist