Provider Demographics
NPI:1790403830
Name:HITE, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 PONTE VEDRA LAKES BLVD APT 3502
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1258
Mailing Address - Country:US
Mailing Address - Phone:240-429-4217
Mailing Address - Fax:
Practice Address - Street 1:611 PONTE VEDRA LAKES BLVD APT 3502
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-1258
Practice Address - Country:US
Practice Address - Phone:240-429-4217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ10814235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist