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General NPI Number Information
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NPI Number | 1174339048
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Entity Type | Individual
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Provider Name | EMILY MICHAEL PARISEAU PHD
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1600 ROCKLAND RD
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City | WILMINGTON
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State | DE
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Zip | 19803-3607
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Country | US
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Telephone | 302-651-5245
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Fax |
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Provider Business Mailing Address
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Address Line | 234 BAINBRIDGE ST REAR 2R
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City | PHILADELPHIA
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State | PA
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Zip | 19147-2323
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Country | US
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Telephone | 401-864-1568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | B1-0011476
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License Number State | DE
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