Provider Demographics
NPI:1447891023
Name:TAFT, EMILY (SLP-CF)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:TAFT
Suffix:
Gender:F
Credentials:SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 E SOUTH RIVER ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-2223
Mailing Address - Country:US
Mailing Address - Phone:920-830-9911
Mailing Address - Fax:
Practice Address - Street 1:1101 E SOUTH RIVER ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-2223
Practice Address - Country:US
Practice Address - Phone:920-830-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4954154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist