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NPI Code Detail

MEDICARE: EMILY HATHAWAY M.S.,CCC-SLP

MEDICARE: EMILY HATHAWAY M.S.,CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist
2235500000XSpeech/Language/Hearing Specialist/Technologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063510899
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY HATHAWAY M.S.,CCC-SLP
Provider Business Mailing Address
First Line : 6905 NW 122ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-3903
Country : US
Telephone Number : 405-603-6622
Fax Number :
Provider Business Practice Location Address
First Line : 6905 NW 122ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-3903
Country : US
Telephone Number : 405-603-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 04/14/2015

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