Provider Demographics
NPI:1689804692
Name:STAEHNKE, EMILEE KAYE (MS CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:KAYE
Last Name:STAEHNKE
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 15TH AVE S STE 105
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-1125
Mailing Address - Country:US
Mailing Address - Phone:701-936-9495
Mailing Address - Fax:
Practice Address - Street 1:4342 15TH AVE S STE 105
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-1125
Practice Address - Country:US
Practice Address - Phone:701-936-9495
Practice Address - Fax:952-222-1994
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist