Doctor Name: | MS. EMILY BETH TRAHAN |
NPI Number: | 1184718983 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LLPC |
License Number: | 6401009995 |
Business Practice Address: | 1501 Krafft Rd Fort Gratiot, MI - 480593565 |
Business Phone Number: | 8002921288 |
Business Fax Number: | 8109855127 |
Mailing Address: | 1501 Krafft Rd, FORT GRATIOT |
State: | MI |
Postal Code: | 480593565 |
Phone Number: | 8002921288 |
Fax Number: | 8109855127 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 01/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401009995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |