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General NPI Number Information
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NPI Number | 1417511692
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Entity Type | Organization
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Legal Business Name | EMERALD CITY THERAPIES, PLLC
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1002 LEGACY RANCH RD STE 104
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1293
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Country | US
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Telephone | 214-980-1397
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Fax | 469-340-4074
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Provider Business Mailing Address
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Address Line | 1002 LEGACY RANCH RD STE 104
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1293
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Country | US
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Telephone | 214-980-1397
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Fax | 469-340-4074
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | MELANIE DAWN REYNOLDS
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Credential | CCC-SLP
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Telephone | 214-679-0235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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