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General NPI Number Information
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NPI Number | 1063834885
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Entity Type | Individual
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Provider Name | JENNIFER MICHELE EMERSON MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 111 ACADEMY DR
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City | MARIETTA
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State | OH
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Zip | 45750-8053
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Country | US
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Telephone | 740-374-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 111 BECKWITH AVE
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City | WILLIAMSTOWN
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State | WV
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Zip | 26187-9722
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Country | US
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Telephone | 740-525-6701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.6912
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License Number State | OH
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