Provider Demographics
NPI:1720544455
Name:EMILY BELTER SLP LLC
Entity Type:Organization
Organization Name:EMILY BELTER SLP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-689-8031
Mailing Address - Street 1:110 S WISCONSIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-2249
Mailing Address - Country:US
Mailing Address - Phone:262-689-8031
Mailing Address - Fax:
Practice Address - Street 1:110 S WISCONSIN ST STE 8
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-2249
Practice Address - Country:US
Practice Address - Phone:262-689-8031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty