Basic Information
| Provider Information | |||||||||
| NPI: | 1598327363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PIERCE | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | M.C.D, CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4601 AMESBURY DR APT 1210 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752060008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184696146 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1803 E US HIGHWAY 243 | ||||||||
| Address2: | |||||||||
| City: | KAUFMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751424118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729327776 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2019 | ||||||||
| LastUpdateDate: | 07/02/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.