Provider Demographics
NPI:1922368018
Name:ORCHARD, EMILY K (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:ORCHARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 E IRONSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-5883
Mailing Address - Country:US
Mailing Address - Phone:208-871-0224
Mailing Address - Fax:
Practice Address - Street 1:263 E IRONSTONE CT
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5883
Practice Address - Country:US
Practice Address - Phone:208-871-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist