Healthcare Provider Details

I. General information

NPI: 1679498067
Provider Name (Legal Business Name): EMILY MAGESKI MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25000 MIDDLEBELT RD
FARMINGTON HILLS MI
48336-1345
US

IV. Provider business mailing address

36554 HEATHERTON DR
FARMINGTON MI
48335-2921
US

V. Phone/Fax

Practice location:
  • Phone: 248-489-3601
  • Fax:
Mailing address:
  • Phone: 248-762-0903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberPP0000001248378
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: