Provider Demographics
NPI:1831923929
Name:RILEY, EMILY S (SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:S
Last Name:RILEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:HUME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6835 SALADIN AVE
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-3681
Mailing Address - Country:US
Mailing Address - Phone:214-500-0116
Mailing Address - Fax:
Practice Address - Street 1:56299 29 PALMS HWY
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2857
Practice Address - Country:US
Practice Address - Phone:760-366-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19839235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist