Provider Demographics
NPI:1467093005
Name:MASSMAN, EMMA MARIE (LICSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MARIE
Last Name:MASSMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:MARIE
Other - Last Name:COZAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1880 AUSTIN RD
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-4543
Mailing Address - Country:US
Mailing Address - Phone:504-214-2016
Mailing Address - Fax:507-214-2017
Practice Address - Street 1:1880 AUSTIN RD
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-4543
Practice Address - Country:US
Practice Address - Phone:504-214-2016
Practice Address - Fax:507-214-2017
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN256001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical