MEDICARE: MS. KATHY JOY EMANS MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801035927	MI

General Provider Information

NPI Number	:	1841293230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHY JOY EMANS MSW

Provider Business Mailing Address
First Line	:	60640 WOODLAND DR
Second Line	:
City	:	DOWAGIAC
State	:	MI
Zip	:	49047-9711
Country	:	US
Telephone Number	:	574-220-3453
Fax Number	:

Provider Business Practice Location Address
First Line	:	960 E. STATE
Second Line	:
City	:	CASSOPOLIS
State	:	MI
Zip	:	49031
Country	:	US
Telephone Number	:	269-445-2451
Fax Number	:	269-445-3216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/06/2013

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