Emily Ruth Badlam, M.A., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Canton, NY

NPI 1205268653 · NPPES record last updated Aug 7, 2013

Key facts

NPI
1205268653
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
023015 (NY)
Practice address
40 W Main St
Canton, NY 13617-1249
Phone
(315) 386-4504
NPI assigned
Aug 7, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
023015NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 023015 NY Yes

Addresses

Primary practice location

40 W Main St
Canton, NY 13617-1249

Mailing address

1212 Washington St
Ogdensburg, NY 13669-1840
Phone (315) 528-9225

Other providers in Canton, NY

All providers in Canton, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.