Provider Demographics
NPI:1467692772
Name:SCHULTZ, EMILY RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RENEE
Last Name:SCHULTZ
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 1:12 WATERCREST N
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:AR
Mailing Address - Zip Code:72007-9595
Mailing Address - Country:US
Mailing Address - Phone:501-843-4605
Mailing Address - Fax:
Practice Address - Street 1:12 WATERCREST N
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:AR
Practice Address - Zip Code:72007-9595
Practice Address - Country:US
Practice Address - Phone:501-843-4605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist