Provider Demographics
NPI:1174996102
Name:BECK, EMILY (MA CF-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6826 RETTON ROAD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:712 N MIAMI AVE
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:OH
Practice Address - Zip Code:45308-1160
Practice Address - Country:US
Practice Address - Phone:937-448-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-13
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2016058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist