Provider Demographics
NPI:1225715329
Name:BROCKWAY, EMILY KAY (APSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAY
Last Name:BROCKWAY
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 WILLIAMSTOWNE STE 101
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2332
Mailing Address - Country:US
Mailing Address - Phone:262-337-9770
Mailing Address - Fax:262-337-9771
Practice Address - Street 1:383 WILLIAMSTOWNE STE 101
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2332
Practice Address - Country:US
Practice Address - Phone:262-337-9770
Practice Address - Fax:262-337-9771
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131873104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker