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General NPI Number Information
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NPI Number | 1891584322
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Entity Type | Individual
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Provider Name | EMILY ROSE FILLICETTI L.AC., MSOM
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 116 N DODGE ST STE 8A
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City | BURLINGTON
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State | WI
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Zip | 53105-1963
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Country | US
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Telephone | 224-388-8790
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Fax |
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Provider Business Mailing Address
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Address Line | 8511 FISHMAN RD
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City | BURLINGTON
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State | WI
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Zip | 53105-9247
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Country | US
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Telephone | 224-388-8970
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 2081-55
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License Number State | WI
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