Provider Demographics
NPI:1932246741
Name:WEAVER, EMILY LOMBARDO (SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:LOMBARDO
Last Name:WEAVER
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 HACKMANN ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4484
Mailing Address - Country:US
Mailing Address - Phone:314-283-3502
Mailing Address - Fax:
Practice Address - Street 1:2107 HACKMANN ESTATES DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-4484
Practice Address - Country:US
Practice Address - Phone:314-283-3502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002009607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist