Provider Demographics
NPI:1760867709
Name:MARSH, EMILY (MA CFY SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MARSH
Suffix:
Gender:F
Credentials:MA CFY SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 NORTH BROADWAY STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331
Mailing Address - Country:US
Mailing Address - Phone:937-548-2317
Mailing Address - Fax:
Practice Address - Street 1:1498 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2454
Practice Address - Country:US
Practice Address - Phone:937-548-2317
Practice Address - Fax:937-548-3055
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2015322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist