Healthcare Provider Details

I. General information

NPI: 1467951327
Provider Name (Legal Business Name): ROBERT EMERY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 N 5TH ST
GRAND JUNCTION CO
81501-7561
US

IV. Provider business mailing address

1006 N 5TH ST
GRAND JUNCTION CO
81501-7561
US

V. Phone/Fax

Practice location:
  • Phone: 970-579-0003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0018684
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: