| Organization Name: | EMILY DYKSTRA MA, CCC-SLP INC. |
| NPI Number: | 1477813129 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMILY ELLEN DYKSTRA (SPEECH LANGUAGE PATHOLOGIST) |
| Mailing Address: | 1146 Woodland Terrace Trl Altamonte Springs |
| State: | FL US |
| Postal Code: | 327141805 |
| Phone Number: | 4079285378 |
| Fax Number: | 4075228293 |
| NPI Enumeration Date: | 05/29/2012 |
| NPI Last Update Date: | 05/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA7153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |