Provider Demographics
NPI:1639627748
Name:KASMER, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:KASMER
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 1:4950 SW 31ST TER
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6951
Mailing Address - Country:US
Mailing Address - Phone:954-240-3023
Mailing Address - Fax:
Practice Address - Street 1:4950 SW 31ST TER
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6951
Practice Address - Country:US
Practice Address - Phone:954-240-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-18
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician