Provider Demographics
NPI:1669029674
Name:DEAN, EMILY (PHD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 HICKORY ST BOX 16225
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79698-0001
Mailing Address - Country:US
Mailing Address - Phone:325-671-5784
Mailing Address - Fax:
Practice Address - Street 1:2200 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2345
Practice Address - Country:US
Practice Address - Phone:325-671-5784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2182174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist