Doctor Name: | EMILIE M WILLIS |
NPI Number: | 1265795488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.H.S, CCC-SLP |
License Number: | SLP 7933 |
Business Practice Address: | 20100 N 51st Ave Suite E-540 Glendale, AZ - 853085125 |
Business Phone Number: | 6235004201 |
Business Fax Number: | |
Mailing Address: | 20100 N 51st Ave, Suite E-540 GLENDALE |
State: | AZ |
Postal Code: | 853085125 |
Phone Number: | 6235002401 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2012 |
NPI Last Update Date: | 03/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP 7933 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |