Provider Demographics
NPI:1427206085
Name:EMERSON, BONNIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9453 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7367
Mailing Address - Country:US
Mailing Address - Phone:954-295-4758
Mailing Address - Fax:954-255-3259
Practice Address - Street 1:9453 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7367
Practice Address - Country:US
Practice Address - Phone:954-295-4758
Practice Address - Fax:954-255-3259
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA-3910235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist