Provider Demographics
NPI:1205208949
Name:LABUKAS, EMILY (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:LABUKAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12425 RIVER RIDGE BLVD
Mailing Address - Street 2:#200
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4871
Mailing Address - Country:US
Mailing Address - Phone:952-562-8500
Mailing Address - Fax:952-562-8315
Practice Address - Street 1:12425 RIVER RIDGE BLVD
Practice Address - Street 2:#200
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4871
Practice Address - Country:US
Practice Address - Phone:952-562-8500
Practice Address - Fax:952-562-8315
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2354106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist