Provider Demographics
NPI:1457757874
Name:GERLOFF, EMILY REBEKAH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:REBEKAH
Last Name:GERLOFF
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 1:1201 AVENUE B
Mailing Address - Street 2:APT 1242
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2300
Mailing Address - Country:US
Mailing Address - Phone:972-413-6255
Mailing Address - Fax:
Practice Address - Street 1:730 N MAIN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1152
Practice Address - Country:US
Practice Address - Phone:210-297-7725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109953235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist