Provider Demographics
NPI:1053059311
Name:EMMERICH, MICHELE CATHERINE (RD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:CATHERINE
Last Name:EMMERICH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:MICHELE
Other - Middle Name:CATHERINE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:239 GRACE LN
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-1775
Mailing Address - Country:US
Mailing Address - Phone:215-806-2390
Mailing Address - Fax:
Practice Address - Street 1:190 W GERMANTOWN PIKE STE 155
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1383
Practice Address - Country:US
Practice Address - Phone:610-229-9060
Practice Address - Fax:610-229-9060
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA857845133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered