Healthcare Provider Details

I. General information

NPI: 1063101079
Provider Name (Legal Business Name): EMILY S HAGER MS, NTP, RWS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CLEARWATER LOOP STE B
POST FALLS ID
83854-9599
US

IV. Provider business mailing address

PO BOX 6702
JACKSON WY
83002-6702
US

V. Phone/Fax

Practice location:
  • Phone: 307-699-7096
  • Fax:
Mailing address:
  • Phone: 307-699-7096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: