Provider Demographics
NPI:1457579294
Name:ADAMS, EMILY ANNE (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:ANNE
Other - Last Name:ROUSSELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:144 LONGMEADOW LN
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-2904
Mailing Address - Country:US
Mailing Address - Phone:814-235-2032
Mailing Address - Fax:814-235-6223
Practice Address - Street 1:REHABCARE, 5500 BROOKTREE ROAD
Practice Address - Street 2:SUITE 102
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:814-235-2032
Practice Address - Fax:814-235-6223
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist