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General NPI Number Information
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NPI Number | 1831059245
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Entity Type | Individual
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Provider Name | EMMA CORNELL BLACKWOOD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2025
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 209 N GROVE MEDICAL PARK DRIVE
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City | SPARTANBURG
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State | SC
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Zip | 29303
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Country | US
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Telephone | 864-345-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 482 VESTRY PL
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City | MOORE
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State | SC
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Zip | 29369-2000
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Country | US
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Telephone | 864-979-2094
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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 | 8536
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License Number State | SC
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