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General NPI Number Information
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NPI Number | 1366840746
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Entity Type | Individual
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Provider Name | EMMA PANEPUCCI M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/18/2018
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Provider Practice Location Address
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Address Line | 6172 AIRWAYS BLVD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2984
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Country | US
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Telephone | 423-622-1551
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Fax | 877-856-7133
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Provider Business Mailing Address
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Address Line | 9675 STATE ROUTE 37
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City | MALTA
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State | OH
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Zip | 43758-9727
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Country | US
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Telephone | 740-342-4873
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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. 10967
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6648
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License Number State | TN
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