Provider Demographics
NPI:1831776459
Name:MYLES, EMILY FENDER (CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FENDER
Last Name:MYLES
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 1:6005 CHESDEN DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8663
Mailing Address - Country:US
Mailing Address - Phone:828-443-3071
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST STE 110
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-0448
Practice Address - Country:US
Practice Address - Phone:704-234-6482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist