Provider Demographics
NPI:1508365966
Name:ESTADES, EMILY (SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ESTADES
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 1:32899 CHARMWOOD OVAL
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4420
Mailing Address - Country:US
Mailing Address - Phone:727-871-1578
Mailing Address - Fax:
Practice Address - Street 1:30325 BAINBRIDGE RD STE 5
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2295
Practice Address - Country:US
Practice Address - Phone:440-498-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty