Basic Information
| Provider Information | |||||||||
| NPI: | 1679181085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCCLELLAND | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | GARRISON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8181 NW 154TH ST STE 210 | ||||||||
| Address2: | |||||||||
| City: | MIAMI LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330165861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055583724 | ||||||||
| FaxNumber: | 7869074485 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 E LAKE HOWARD DR | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338813155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632991251 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2020 | ||||||||
| LastUpdateDate: | 03/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY2380 | FL | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.