=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407619331
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMMALEIGH LOYER MS, CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/02/2024
-----------------------------------------------------
Last Update Date | 02/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 790 COLLEGE PKWY
-----------------------------------------------------
City | COLCHESTER
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05446-3007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-847-3940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 166 MAPLEWOOD DR
-----------------------------------------------------
City | SHELBURNE
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05482-6647
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 144.0134707
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------