Provider Demographics
NPI:1942431382
Name:SHAKRO, EMILY K (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:K
Last Name:SHAKRO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:K
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 S PLAYERS CLUB DR
Mailing Address - Street 2:APT 25204
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-5135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S PLAYERS CLUB DR
Practice Address - Street 2:APT 25204
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-5135
Practice Address - Country:US
Practice Address - Phone:630-306-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2014-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP 8545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist