Provider Demographics
NPI:1356529143
Name:CARL, EMILY WHITLOW (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:WHITLOW
Last Name:CARL
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6304 COACHMAN DR N
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3028
Mailing Address - Country:US
Mailing Address - Phone:757-295-6698
Mailing Address - Fax:
Practice Address - Street 1:3216 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5440
Practice Address - Country:US
Practice Address - Phone:757-651-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
VA2202005428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist