Provider Demographics
NPI:1417732637
Name:CONKIN, EMILY FABEL (SLP CF)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:FABEL
Last Name:CONKIN
Suffix:
Gender:F
Credentials:SLP CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 E FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-2860
Mailing Address - Country:US
Mailing Address - Phone:423-928-6464
Mailing Address - Fax:
Practice Address - Street 1:2214 E FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2860
Practice Address - Country:US
Practice Address - Phone:423-928-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist