Provider Demographics
NPI:1346801594
Name:MCROBERTS, EMILY ANN (LMT)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ANN
Last Name:MCROBERTS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 BENEDICT LN
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-2009
Mailing Address - Country:US
Mailing Address - Phone:586-907-3570
Mailing Address - Fax:
Practice Address - Street 1:3190 ROCHESTER RD STE 107
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5464
Practice Address - Country:US
Practice Address - Phone:248-264-3338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501011431225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist