| Doctor Name: | EMMA TYLER-BOLTREK |
| NPI Number: | 1134538457 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 5481 |
| Business Practice Address: | 826 Camino Del Monte Rey Suite A2 Santa Fe, NM - 875053977 |
| Business Phone Number: | 5059549940 |
| Business Fax Number: | |
| Mailing Address: | 921 1/2 Don Juan St, SANTA FE |
| State: | NM |
| Postal Code: | 875012409 |
| Phone Number: | 5055709169 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2014 |
| NPI Last Update Date: | 08/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 5481 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |