Provider Demographics
NPI:1639535933
Name:SOULE, EMILY (MSED)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SOULE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSED
Mailing Address - Street 1:687 MYRTLE AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3711
Mailing Address - Country:US
Mailing Address - Phone:315-409-5019
Mailing Address - Fax:
Practice Address - Street 1:687 MYRTLE AVE
Practice Address - Street 2:APT 1
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3711
Practice Address - Country:US
Practice Address - Phone:315-409-5019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1244233174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist