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NPI Code Detail

MEDICARE: EMILY CLARE WALSH CCC-SLP

MEDICARE: EMILY CLARE WALSH 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 Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1030317OTHERNYSLP LICENSE/REGISTRATION
214340446OTHERASHA CCC-SLP

General Provider Information

NPI Number : 1871051805
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CLARE WALSH CCC-SLP
Provider Business Mailing Address
First Line : 1201 66TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-5914
Country : US
Telephone Number : 908-907-8903
Fax Number :
Provider Business Practice Location Address
First Line : 1201 66TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-5914
Country : US
Telephone Number : 718-259-4389
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2019
Last Update Date : 11/22/2020

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Directions to “ EMILY CLARE WALSH CCC-SLP” Practice Location

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