Emily Marie Braden, MS

Individual provider Active NPI Speech-Language Pathologist · Fairfield, IL

NPI 1225812902 · NPPES record last updated Aug 23, 2023

Key facts

NPI
1225812902
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2519064 (IL)
Practice address
806 N 1St St
Fairfield, IL 62837-2458
Phone
(618) 384-8998
NPI assigned
Aug 23, 2023
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 Science

State licenses

LicenseStateTypeSpecialty
2519064ILMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2519064 IL Yes

Addresses

Primary practice location

806 N 1St St
Fairfield, IL 62837-2458

Mailing address

16176 County Road 1900 N
Springerton, IL 62887-2154
Phone (618) 384-8998

Other names

  • Emily Marie Blades Former name

Other providers in Fairfield, IL

All providers in Fairfield, IL · Speech-Language Pathologist in Illinois

Sources for this page

Verify at the official NPI Registry.