Provider Demographics
NPI:1689028326
Name:LOURASH, EMILY KATHRYN (SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHRYN
Last Name:LOURASH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:KATHRYN
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1824 TOUBY PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-2573
Mailing Address - Country:US
Mailing Address - Phone:765-628-7400
Mailing Address - Fax:765-450-6453
Practice Address - Street 1:1834 FIELDS BLVD
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-3029
Practice Address - Country:US
Practice Address - Phone:317-527-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46002914A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300025008Medicaid