MEDICARE: MRS. EMILY REBECCA RHODE MS-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
1	235Z00000X	Speech-Language Pathologist	2814	WI

General Provider Information

NPI Number	:	1659311140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY REBECCA RHODE MS-CCC/SLP

Provider Business Mailing Address
First Line	:	2745 PICKEREL POINT LN
Second Line	:
City	:	EAGLE RIVER
State	:	WI
Zip	:	54521-8347
Country	:	US
Telephone Number	:	715-479-5079
Fax Number	:	715-545-3165

Provider Business Practice Location Address
First Line	:	2745 PICKEREL POINT LN
Second Line	:
City	:	EAGLE RIVER
State	:	WI
Zip	:	54521-8347
Country	:	US
Telephone Number	:	715-479-5079
Fax Number	:	715-545-3165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	07/08/2007

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Directions to “ MRS. EMILY REBECCA RHODE MS-CCC/SLP” Practice Location

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