Provider Demographics
NPI:1437795911
Name:BERRIOCHOA, EMILY ALLEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ALLEN
Last Name:BERRIOCHOA
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 1:124 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-3821
Mailing Address - Country:US
Mailing Address - Phone:801-678-1277
Mailing Address - Fax:
Practice Address - Street 1:124 COLONIAL AVE
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-3821
Practice Address - Country:US
Practice Address - Phone:801-678-1277
Practice Address - Fax:801-820-2859
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115359235Z00000X
AZSLP12014235Z00000X
UT6967116-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist