Provider Demographics
NPI:1811136021
Name:NADLER, ELIZABETH 'EMMA' (MA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:'EMMA'
Last Name:NADLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13100 WAYZATA BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1821
Mailing Address - Country:US
Mailing Address - Phone:952-542-4862
Mailing Address - Fax:952-593-1778
Practice Address - Street 1:13100 WAYZATA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1821
Practice Address - Country:US
Practice Address - Phone:952-542-4862
Practice Address - Fax:952-593-1778
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPC00595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health