Provider Demographics
NPI:1760055487
Name:PFOUTZ, EMILY BLAIR (MA SLP-CF)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:BLAIR
Last Name:PFOUTZ
Suffix:
Gender:F
Credentials:MA SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S 49TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-4204
Mailing Address - Country:US
Mailing Address - Phone:413-687-3972
Mailing Address - Fax:
Practice Address - Street 1:801 W 18TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3852
Practice Address - Country:US
Practice Address - Phone:302-651-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist