Provider Demographics
NPI:1679446603
Name:DEHART, EMILY FAYE (CLC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:FAYE
Last Name:DEHART
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-3318
Mailing Address - Country:US
Mailing Address - Phone:208-965-0545
Mailing Address - Fax:
Practice Address - Street 1:404 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-3165
Practice Address - Country:US
Practice Address - Phone:254-265-1409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXALPP-368066174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN