Provider Demographics
NPI:1164298220
Name:DAVIS, EMILEE C (ATR-BC, LPAT)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:C
Last Name:DAVIS
Suffix:
Gender:F
Credentials:ATR-BC, LPAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 E 39TH ST STE 602
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0123
Mailing Address - Country:US
Mailing Address - Phone:201-416-9587
Mailing Address - Fax:
Practice Address - Street 1:6 E 39TH ST STE 602
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0123
Practice Address - Country:US
Practice Address - Phone:201-416-9587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16LP00010800221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist