Provider Demographics
NPI:1568140374
Name:FERGUSON, EMILY MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE CHILDREN'S PLACE
Mailing Address - Street 2:MAIL STOP: 90-49-023
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1077
Mailing Address - Country:US
Mailing Address - Phone:314-454-6171
Mailing Address - Fax:
Practice Address - Street 1:ONE CHILDREN'S PLACE
Practice Address - Street 2:MAIL STOP: 90-49-023
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1077
Practice Address - Country:US
Practice Address - Phone:314-454-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023027352231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist