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General NPI Number Information
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NPI Number | 1184938342
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Entity Type | Individual
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Provider Name | EMILY KAREN CHILDRESS EMILY CHILDRESS
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Gender | Female
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Dates
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Enumeration Date | 07/29/2010
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 362 RALEIGH ST
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-9047
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Country | US
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Telephone | 984-363-9195
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Fax | 515-233-6500
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Provider Business Mailing Address
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Address Line | 120 AVENT PINES LN
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540-8618
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Country | US
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Telephone | 984-363-9195
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000322
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License Number State | IA
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