Individual
EMERSON BLAKE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SLPA
Contact information
Practice address
5809 W VOGEL AVE, GLENDALE, AZ 85302-3123
(623) 703-8167
Mailing address
5809 W VOGEL AVE, GLENDALE, AZ 85302-3123
(623) 703-8167
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA12215
AZ
2355S0801X
Speech-Language Assistant
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Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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