Individual
EMILL AJILAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS. CCC-SLP
Contact information
Practice address
47391 WESTLAKE DR, SHELBY TOWNSHIP, MI 48315-4555
(586) 383-1291
Mailing address
47391 WESTLAKE DR, SHELBY TOWNSHIP, MI 48315-4555
(586) 383-1291
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101007355
MI
247200000X
Other Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7101007355
BOARD OF SPEECH LANGUAGE PATHOLOGY LICENSE
MI
Enumeration date
09/22/2015
Last updated
08/31/2021
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