Provider Demographics
NPI:1023835303
Name:DOLL, EMMA KATE
Entity type:Individual
Prefix:MRS
First Name:EMMA
Middle Name:KATE
Last Name:DOLL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:EMMA
Other - Middle Name:KATE
Other - Last Name:TULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2735 N JENNIE BARKER RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-9077
Mailing Address - Country:US
Mailing Address - Phone:620-275-0291
Mailing Address - Fax:
Practice Address - Street 1:2735 N JENNIE BARKER RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-9077
Practice Address - Country:US
Practice Address - Phone:620-275-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist