Healthcare Provider Details

I. General information

NPI: 1043137540
Provider Name (Legal Business Name): JASMINE EMERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 S TELEGRAPH RD STE L184
BLOOMFIELD HILLS MI
48302-0241
US

IV. Provider business mailing address

2510 S TELEGRAPH RD STE L184
BLOOMFIELD HILLS MI
48302-0241
US

V. Phone/Fax

Practice location:
  • Phone: 231-632-7996
  • Fax:
Mailing address:
  • Phone: 231-632-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851121661
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: