Provider Demographics
NPI:1699026732
Name:SHULTZ, EMILY H M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:H M
Last Name:SHULTZ
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 1:25621 140TH AVE SE
Mailing Address - Street 2:KENT SCHOOL DISTRICT, MERIDIAN ELEMENTARY
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-3601
Mailing Address - Country:US
Mailing Address - Phone:253-373-3130
Mailing Address - Fax:
Practice Address - Street 1:25621 140TH AVE SE
Practice Address - Street 2:KENT SCHOOL DISTRICT, MERIDIAN ELEMENTARY
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-3601
Practice Address - Country:US
Practice Address - Phone:253-373-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60172772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist