Provider Demographics
NPI:1659424794
Name:BLUMBERG, EMILY BETH (MS, CCC-SLP, CEIS)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BETH
Last Name:BLUMBERG
Suffix:
Gender:F
Credentials:MS, CCC-SLP, CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PINE RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1626
Mailing Address - Country:US
Mailing Address - Phone:978-496-1037
Mailing Address - Fax:
Practice Address - Street 1:32 PINE RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:MA
Practice Address - Zip Code:01886-1626
Practice Address - Country:US
Practice Address - Phone:978-496-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist