Provider Demographics
NPI:1689893471
Name:DAUCH, EMILIE (LLP)
Entity Type:Individual
Prefix:MS
First Name:EMILIE
Middle Name:
Last Name:DAUCH
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6555 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4926
Mailing Address - Country:US
Mailing Address - Phone:248-592-2671
Mailing Address - Fax:248-592-2660
Practice Address - Street 1:6555 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4926
Practice Address - Country:US
Practice Address - Phone:248-592-2671
Practice Address - Fax:248-592-2660
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005490103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist