Provider Demographics
NPI:1649700667
Name:WAUGH, EMILY KATHRYN (AUD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KATHRYN
Last Name:WAUGH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4360
Mailing Address - Country:US
Mailing Address - Phone:410-879-9100
Mailing Address - Fax:410-638-0408
Practice Address - Street 1:9103 FRANKLIN SQUARE DR STE 302
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3939
Practice Address - Country:US
Practice Address - Phone:410-248-6300
Practice Address - Fax:410-682-3257
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01413231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD200285000Medicaid