Provider Demographics
NPI:1235957663
Name:ELMQUIST, EMILY (MSW CLINICAL INTERN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ELMQUIST
Suffix:
Gender:F
Credentials:MSW CLINICAL INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 GILMORE AVE
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-3582
Mailing Address - Country:US
Mailing Address - Phone:608-354-7637
Mailing Address - Fax:
Practice Address - Street 1:1159 GILMORE AVE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3582
Practice Address - Country:US
Practice Address - Phone:608-354-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical