Provider Demographics
NPI:1255103131
Name:BECKER, EMILY MEGAN (MA CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MEGAN
Last Name:BECKER
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 1:4833 CARNOUSTIE CT
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8974
Mailing Address - Country:US
Mailing Address - Phone:843-730-4631
Mailing Address - Fax:
Practice Address - Street 1:4833 CARNOUSTIE CT
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8974
Practice Address - Country:US
Practice Address - Phone:843-730-4631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8174235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist