Provider Demographics
NPI:1972659373
Name:EMANUEL, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:EMANUEL
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 1:205 SOUTH ST E
Mailing Address - Street 2:
Mailing Address - City:TALLADEGA
Mailing Address - State:AL
Mailing Address - Zip Code:35160-2411
Mailing Address - Country:US
Mailing Address - Phone:256-761-3303
Mailing Address - Fax:256-761-3485
Practice Address - Street 1:205 SOUTH ST E
Practice Address - Street 2:
Practice Address - City:TALLADEGA
Practice Address - State:AL
Practice Address - Zip Code:35160-2411
Practice Address - Country:US
Practice Address - Phone:256-761-3303
Practice Address - Fax:256-761-3485
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1005235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist