| Kristin Emanuel Llc | |
|
3408 Niles Rd Saint Joseph MI 49085-8628 | |
| (269) 428-4789 | |
| Not Available |
| Full Name | Kristin Emanuel Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3408 Niles Rd, Saint Joseph, Michigan |
| Authorized Official Name and Position | Kristin Emanuel (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 2694284789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kristin Emanuel Llc 3408 Niles Rd Saint Joseph MI 49085-8628 Ph: () - | Kristin Emanuel Llc 3408 Niles Rd Saint Joseph MI 49085-8628 Ph: (269) 428-4789 |
| NPI Number | 1326590928 |
|---|---|
| Provider Enumeration Date | 10/30/2016 |
| Last Update Date | 10/30/2016 |
| Medicare PECOS PAC ID | 1658655006 |
|---|---|
| Medicare Enrollment ID | O20170302000558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326590928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301015211 (Michigan) | Primary |
| Provider Name | Kristin M Emanuel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225323280 PECOS PAC ID: 7113241720 Enrollment ID: I20150129002465 |
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