Provider Demographics
NPI:1841584869
Name:CIPALLA, EMILY TINLEY (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:TINLEY
Last Name:CIPALLA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 JENNINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-9431
Mailing Address - Country:US
Mailing Address - Phone:910-465-5537
Mailing Address - Fax:
Practice Address - Street 1:2744 S 17TH ST
Practice Address - Street 2:GENESIS REHABILITATION
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6606
Practice Address - Country:US
Practice Address - Phone:910-794-3319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist