Provider Demographics
NPI:1982379665
Name:METZ, EMMA
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:METZ
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 1:9320 OTIS AVENUE
Mailing Address - Street 2:APT. 2411
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-2325
Mailing Address - Country:US
Mailing Address - Phone:417-360-0433
Mailing Address - Fax:
Practice Address - Street 1:975 W WALNUT ST # IB-130
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5181
Practice Address - Country:US
Practice Address - Phone:417-360-0433
Practice Address - Fax:317-968-1354
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99105554A170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS