Provider Demographics
NPI:1174937767
Name:WARRNER-NIX, EMILY (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WARRNER-NIX
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1698 WINGSPAN WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5927
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11602 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 129
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4458
Practice Address - Country:US
Practice Address - Phone:407-384-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13962235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist