Provider Demographics
NPI:1427548890
Name:MANTON, EMILY K
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:MANTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 BLACK WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-8203
Mailing Address - Country:US
Mailing Address - Phone:401-477-0022
Mailing Address - Fax:
Practice Address - Street 1:1305 W WENDOVER AVE STE C
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8100
Practice Address - Country:US
Practice Address - Phone:336-279-9008
Practice Address - Fax:336-740-9099
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-11
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist