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NPI Code Detail

MEDICARE: EMILY BRICKEY MA CCC-SLP

MEDICARE:   EMILY  BRICKEY  MA CCC-SLP
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 Pathologist114896TX

General Provider Information

NPI Number : 1053893941
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY BRICKEY MA CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 9383
Second Line :
City : MIDLAND
State : TX
Zip : 79708-9383
Country : US
Telephone Number : 713-459-5422
Fax Number :
Provider Business Practice Location Address
First Line : 1020 N COUNTY RD W
Second Line :
City : ODESSA
State : TX
Zip : 79763-3436
Country : US
Telephone Number : 432-332-0371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2018
Last Update Date : 09/06/2018

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Directions to “ EMILY BRICKEY MA CCC-SLP” Practice Location

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