Provider Demographics
NPI:1225416209
Name:FASHING, EMMA (BSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:FASHING
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 E JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1507
Mailing Address - Country:US
Mailing Address - Phone:608-346-7942
Mailing Address - Fax:
Practice Address - Street 1:2810 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-7942
Practice Address - Country:US
Practice Address - Phone:608-346-7942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker