Healthcare Provider Details

I. General information

NPI: 1083350557
Provider Name (Legal Business Name): EMILY ENGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SAINT ANDREWS CT STE 310
MANKATO MN
56001-8805
US

IV. Provider business mailing address

PO BOX 8674
MANKATO MN
56002-8674
US

V. Phone/Fax

Practice location:
  • Phone: 507-625-1811
  • Fax: 507-625-4754
Mailing address:
  • Phone: 507-625-1811
  • Fax: 507-625-4754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number107950
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: