Provider Demographics
NPI:1770862278
Name:SIEMER, EMILY C (SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:SIEMER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W ELM ST
Mailing Address - Street 2:SPECIAL SERVICES
Mailing Address - City:WINFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63389-1102
Mailing Address - Country:US
Mailing Address - Phone:636-668-8188
Mailing Address - Fax:
Practice Address - Street 1:701 W ELM ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:MO
Practice Address - Zip Code:63389-1102
Practice Address - Country:US
Practice Address - Phone:636-668-8188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011025062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist