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NPI Code Detail

MEDICARE: EMILY WYATT

MEDICARE: EMILY WYATT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist104261TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112155165OTHERAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION

General Provider Information

NPI Number : 1053080119
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY WYATT
Provider Business Mailing Address
First Line : 1820 PEARL ST BLDG C
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-6120
Country : US
Telephone Number : 972-968-5800
Fax Number :
Provider Business Practice Location Address
First Line : 1820 PEARL ST BLDG C
Second Line :
City : CARROLLTON
State : TX
Zip : 75006-6120
Country : US
Telephone Number : 972-968-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2021
Last Update Date : 07/24/2025

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Directions to “ EMILY WYATT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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