Provider Demographics
NPI:1295109353
Name:KIRSCHENBLATT, EMILY BRYANT (MS LCGC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BRYANT
Last Name:KIRSCHENBLATT
Suffix:
Gender:F
Credentials:MS LCGC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS LCGC
Mailing Address - Street 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2507
Mailing Address - Country:US
Mailing Address - Phone:651-578-5037
Mailing Address - Fax:651-312-3148
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-578-5037
Practice Address - Fax:651-312-3148
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1379170300000X
IL246.000230170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS