Emily R Peters, MS CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Osceloa, IN

NPI 1992437792 · NPPES record last updated Jun 29, 2022

Key facts

NPI
1992437792
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
22007795A (IN)
Practice address
1415 LWW
Ste. M.
Osceloa, IN 46561
Phone
(574) 675-7767
NPI assigned
Jun 29, 2022
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
22007795AINMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22007795A IN Yes

Addresses

Primary practice location

1415 LWW
Ste. M.
Osceloa, IN 46561

Mailing address

4211 Governors Blvd Apt G
South Bend, IN 46637-4020
Phone (219) 688-5415

Other names

  • Ms. Emily R Peters Professional name

Sources for this page

Verify at the official NPI Registry.