Provider Demographics
NPI:1336828995
Name:BUDWAY, EMMA (MA, CF-SLP)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:BUDWAY
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 JUDGE HASTY LN
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7320
Mailing Address - Country:US
Mailing Address - Phone:207-561-0311
Mailing Address - Fax:
Practice Address - Street 1:75 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4797
Practice Address - Country:US
Practice Address - Phone:207-874-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST3967235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist