Provider Demographics
NPI:1689966574
Name:HIRLEMAN, EMILY DIANE (CCP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DIANE
Last Name:HIRLEMAN
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2753 E BROADWAY RD # 101-454
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-1579
Mailing Address - Country:US
Mailing Address - Phone:480-659-6964
Mailing Address - Fax:480-659-6791
Practice Address - Street 1:2753 E BROADWAY RD # 101-454
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-1579
Practice Address - Country:US
Practice Address - Phone:480-659-6964
Practice Address - Fax:480-659-6791
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist