MEDICARE: MS. EMMA L. DAUPHINAIS M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1043074321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMMA L. DAUPHINAIS M.S.

Provider Business Mailing Address
First Line	:	34 MARK CIR
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520-1410
Country	:	US
Telephone Number	:	508-340-3465
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 MARK CIR
Second Line	:
City	:	HOLDEN
State	:	MA
Zip	:	01520-1410
Country	:	US
Telephone Number	:	508-340-3465
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2024
Last Update Date	:	02/07/2024

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