Provider Demographics
NPI:1265002679
Name:SESSOMS, EMILY T
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:T
Last Name:SESSOMS
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 1:37895 ROW RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DORENA
Mailing Address - State:OR
Mailing Address - Zip Code:97434-9610
Mailing Address - Country:US
Mailing Address - Phone:132-126-2332
Mailing Address - Fax:
Practice Address - Street 1:37 N 6TH ST
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-2012
Practice Address - Country:US
Practice Address - Phone:541-942-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health