Provider Demographics
NPI:1255707816
Name:TROUTMAN, EMILY (AUD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:TROUTMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WALLACE BASHAW WAY
Mailing Address - Street 2:SUITE 3002
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3875
Mailing Address - Country:US
Mailing Address - Phone:978-997-1550
Mailing Address - Fax:
Practice Address - Street 1:1 WALLACE BASHAW WAY
Practice Address - Street 2:SUITE 3002
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3875
Practice Address - Country:US
Practice Address - Phone:978-997-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1062231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist