MEDICARE: EMILY LAIT SILVA MS, 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
1	235Z00000X	Speech-Language Pathologist	13533	NC

General Provider Information

NPI Number	:	1710544234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY LAIT SILVA MS, CCC-SLP

Provider Business Mailing Address
First Line	:	412 TRAMWAY WEST RD
Second Line	:
City	:	SANFORD
State	:	NC
Zip	:	27330-9158
Country	:	US
Telephone Number	:	919-418-3667
Fax Number	:	919-375-2538

Provider Business Practice Location Address
First Line	:	7125 WINTER POND WAY
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-5486
Country	:	US
Telephone Number	:	919-348-9174
Fax Number	:	919-375-2538

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2019
Last Update Date	:	09/18/2024

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