Provider Demographics
NPI:1144097718
Name:MOHR, EMILY ANNE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:MOHR
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6674
Mailing Address - Country:US
Mailing Address - Phone:810-357-9255
Mailing Address - Fax:
Practice Address - Street 1:2990 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6674
Practice Address - Country:US
Practice Address - Phone:810-357-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24414087235Z00000X
GASLP009016235Z00000X
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist