1457579294 NPI number — MS. EMILY ANNE ADAMS MS CCC SLP

Table of content: MS. EMILY ANNE ADAMS MS CCC SLP (NPI 1457579294)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457579294 NPI number — MS. EMILY ANNE ADAMS MS CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS
Provider First Name:
EMILY
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROUSSELL
Provider Other First Name:
EMILY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS CCC SLP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457579294
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 LONGMEADOW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATE COLLEGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16803-2904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-235-2032
Provider Business Mailing Address Fax Number:
814-235-6223

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
REHABCARE, 5500 BROOKTREE ROAD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
WEXFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15090-9260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-235-2032
Provider Business Practice Location Address Fax Number:
814-235-6223
Provider Enumeration Date:
04/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SL008601 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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