Emily Maybelle-Wilson Douglas

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101005499 Issued in MI

Practice address

1001 Laurence Ave Ste E
Jackson, MI 49202-2980

Phone

(517) 750-4777

Fax

(517) 782-4717

NPI assigned

Mar 20, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Emily Maybelle Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Comprehensive Speech and Therapy Center, Inc

  • Behavior Analyst
  • Jackson, MI
  • NPI 1447848049
  NPD (past)
• Comprehensive Speech and Therapy Center, Inc

  • Rehabilitation Clinic/Center
  • Jackson, MI
  • NPI 1457473480
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1487158010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N MAPLE ST",
            "city": "FOWLERVILLE",
            "state": "MI",
            "postal_code": "488369502",
            "telephone_number": "661-808-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE STE E",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022980",
            "telephone_number": "517-750-4777",
            "fax_number": "517-782-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "EMILY",
        "middle_name": "MAYBELLE-WILSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WILSON",
            "middle_name": "MAYBELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Doree
• Dot Tetreault, LMSW, Acsw PLLC
• Brad Allen Double, DC
• Mark Double, D.O.
• Kyle Wayne Doughty, DO
• Mya E Douglas
• Dove Health Alliance, Inc.
• Elizabeth A Dow
• Samuel D Dow
• Kylie Marie Downing

• Speech-Language Pathologist in Jackson, MI
• Providers in Jackson, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.