Provider Demographics
NPI:1447146295
Name:WELBORN, EMILY PAIGE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PAIGE
Last Name:WELBORN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1214
Mailing Address - Country:US
Mailing Address - Phone:267-907-3581
Mailing Address - Fax:
Practice Address - Street 1:928 JAYMOR RD STE C-150
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3832
Practice Address - Country:US
Practice Address - Phone:215-330-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL017894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist