Provider Demographics
NPI:1477305639
Name:NUSYMOWICZ, EMILY MICHELLE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MICHELLE
Last Name:NUSYMOWICZ
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 1:103 FENNERTON RD
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1143
Mailing Address - Country:US
Mailing Address - Phone:954-258-2215
Mailing Address - Fax:
Practice Address - Street 1:1416 POWELL ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3326
Practice Address - Country:US
Practice Address - Phone:954-258-2215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist