Provider Demographics
NPI:1770861676
Name:FINTAK, EMILY ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:FINTAK
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 1:280 N MAIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-6136
Mailing Address - Country:US
Mailing Address - Phone:801-292-8665
Mailing Address - Fax:801-292-8667
Practice Address - Street 1:280 N MAIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-6136
Practice Address - Country:US
Practice Address - Phone:801-292-8665
Practice Address - Fax:801-292-8667
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7999722-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist