Provider Demographics
NPI:1134726847
Name:ALMACDDISSI, EMILY FARHAT (MSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FARHAT
Last Name:ALMACDDISSI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:FARHAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4000 NW 51ST ST APT B24
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4334
Mailing Address - Country:US
Mailing Address - Phone:734-560-9447
Mailing Address - Fax:
Practice Address - Street 1:4000 NW 51ST ST APT B24
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-4334
Practice Address - Country:US
Practice Address - Phone:734-560-9447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW209431041C0700X
MI68011155931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical