Provider Demographics
NPI:1326405796
Name:MOHR, EMILY (MS, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:MOHR
Suffix:
Gender:F
Credentials:MS, LMFTA
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:9011 158TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-614-7342
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:16150 NE 85TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-558-0558
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2017-11-17
Deactivation Date:2016-12-30
Deactivation Code:
Reactivation Date:2017-01-23
Provider Licenses
StateLicense IDTaxonomies
WA390200000X
163471390200000X
WAMG60755902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program