Provider Demographics
NPI:1952974123
Name:DRAKE, EMILY MARIE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:DRAKE
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 1:24 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3744
Mailing Address - Country:US
Mailing Address - Phone:603-209-6282
Mailing Address - Fax:
Practice Address - Street 1:24 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-3744
Practice Address - Country:US
Practice Address - Phone:603-209-6282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist