Provider Demographics
NPI:1467660373
Name:CRETEAU, EMILY TILTON (SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:TILTON
Last Name:CRETEAU
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1018
Mailing Address - Country:US
Mailing Address - Phone:207-752-1153
Mailing Address - Fax:
Practice Address - Street 1:19 WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1018
Practice Address - Country:US
Practice Address - Phone:207-752-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist