Provider Demographics
NPI:1760825863
Name:RIOS, EMILIO JR (MS CCC SLP)
Entity Type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:
Last Name:RIOS
Suffix:JR
Gender:M
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 1:49841 CINNABAR LN
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-5394
Mailing Address - Country:US
Mailing Address - Phone:760-619-4624
Mailing Address - Fax:
Practice Address - Street 1:49841 CINNABAR LN
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-5394
Practice Address - Country:US
Practice Address - Phone:760-619-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 17628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist