Provider Demographics
NPI:1285205724
Name:DEIHL, EMMA CLARE (MA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:CLARE
Last Name:DEIHL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 SILVER MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-4194
Mailing Address - Country:US
Mailing Address - Phone:952-994-3890
Mailing Address - Fax:
Practice Address - Street 1:5101 BOARSHEAD RD APT 324
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4059
Practice Address - Country:US
Practice Address - Phone:952-994-3890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health