Provider Demographics
NPI:1538952866
Name:KRIDLER, EMMA KATE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:KATE
Last Name:KRIDLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WATER ST APT 7
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2458
Mailing Address - Country:US
Mailing Address - Phone:814-706-9393
Mailing Address - Fax:
Practice Address - Street 1:555 RAIN FOREST RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5847
Practice Address - Country:US
Practice Address - Phone:865-200-8238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL0177218235Z00000X
NY032062235Z00000X
TN8126235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist