Provider Demographics
NPI:1659311140
Name:RHODE, EMILY REBECCA (MS-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:REBECCA
Last Name:RHODE
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 1:2745 PICKEREL POINT LN
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:WI
Mailing Address - Zip Code:54521-8347
Mailing Address - Country:US
Mailing Address - Phone:715-479-5079
Mailing Address - Fax:715-545-3165
Practice Address - Street 1:2745 PICKEREL POINT LN
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:WI
Practice Address - Zip Code:54521-8347
Practice Address - Country:US
Practice Address - Phone:715-479-5079
Practice Address - Fax:715-545-3165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2814235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist