Provider Demographics
NPI:1235890898
Name:SKOGSETH, EMMA MARGRETE
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MARGRETE
Last Name:SKOGSETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 HIGH TIMBERS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-7161
Mailing Address - Country:US
Mailing Address - Phone:616-255-5128
Mailing Address - Fax:
Practice Address - Street 1:2520 UNIVERSITY PARK BLDG D
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-4464
Practice Address - Country:US
Practice Address - Phone:989-774-2073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician