Provider Demographics
NPI:1508151374
Name:SWEET, EMILY (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SWEET
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 1:1 RUNYON AVE APT A
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817
Mailing Address - Country:US
Mailing Address - Phone:908-208-0752
Mailing Address - Fax:
Practice Address - Street 1:1 RUNYON AVE APT A
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817
Practice Address - Country:US
Practice Address - Phone:908-208-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00649000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist