Healthcare Provider Details

I. General information

NPI: 1659207124
Provider Name (Legal Business Name): EMMA M MAASKE CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8703 HIGHWAY 17 BYP S STE I
MYRTLE BEACH SC
29575-7701
US

IV. Provider business mailing address

8703 HIGHWAY 17 BYP S STE I
MYRTLE BEACH SC
29575-7701
US

V. Phone/Fax

Practice location:
  • Phone: 843-457-1053
  • Fax: 843-215-2910
Mailing address:
  • Phone: 843-457-1053
  • Fax: 843-215-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12041201
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: