Provider Demographics
NPI:1881387108
Name:CROSSLAND, EMMA HALLER (MS)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:HALLER
Last Name:CROSSLAND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:MCGARRY
Other - Last Name:HALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 BERROW WAY
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1744 SAM RITTENBERG BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4935
Practice Address - Country:US
Practice Address - Phone:843-474-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist