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General NPI Number Information
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NPI Number | 1477064822
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Entity Type | Individual
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Provider Name | EMILY ELIZABETH CAVANAGH SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 10/12/2017
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 4680 11TH ST
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City | EAST MOLINE
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State | IL
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Zip | 61244-4428
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Country | US
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Telephone | 309-792-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 1875 HARDING CT
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City | BETTENDORF
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State | IA
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Zip | 52722-3930
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Country | US
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Telephone |
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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 | 242004447
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License Number State | IL
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