Provider Demographics
NPI:1477066934
Name:SLENTZ, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SLENTZ
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 1:693 NY-51
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13776
Mailing Address - Country:US
Mailing Address - Phone:607-783-2207
Mailing Address - Fax:
Practice Address - Street 1:693 NY-51
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13776
Practice Address - Country:US
Practice Address - Phone:607-783-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist