Provider Demographics
NPI:1669950796
Name:NAKOS, EMILY PRUITT (CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PRUITT
Last Name:NAKOS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8430 UNIVERSITY EXEC PARK DR STE 670
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1300
Mailing Address - Country:US
Mailing Address - Phone:980-585-1793
Mailing Address - Fax:704-540-1443
Practice Address - Street 1:8430 UNIVERSITY EXEC PARK DR STE 670
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1300
Practice Address - Country:US
Practice Address - Phone:980-585-1793
Practice Address - Fax:704-540-1443
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist