Provider Demographics
NPI:1245013887
Name:EGERSHEIM, EMILY CLARE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CLARE
Last Name:EGERSHEIM
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 1:55 COMO RD
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-1904
Mailing Address - Country:US
Mailing Address - Phone:781-223-0570
Mailing Address - Fax:
Practice Address - Street 1:55 COMO RD
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:MA
Practice Address - Zip Code:02136-1904
Practice Address - Country:US
Practice Address - Phone:781-223-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor