Provider Demographics
NPI:1720285554
Name:ADAMS, EMILY JEAN (AUD)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JEAN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-7489
Mailing Address - Fax:314-432-8208
Practice Address - Street 1:605 OLD BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7000
Practice Address - Country:US
Practice Address - Phone:314-362-7489
Practice Address - Fax:314-432-8208
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003011272231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1020600009Medicare UPIN