Healthcare Provider Details

I. General information

NPI: 1487238564
Provider Name (Legal Business Name): EMMEE A LAROSE CF, SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 05/05/2021
Certification Date: 05/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 NORD AVE APT 457
CHICO CA
95926-4655
US

IV. Provider business mailing address

729 NORD AVE APT 457
CHICO CA
95926-4655
US

V. Phone/Fax

Practice location:
  • Phone: 530-321-3479
  • Fax:
Mailing address:
  • Phone: 530-321-3479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: