Provider Demographics
NPI:1174396907
Name:SAWYER, EMMA JANE
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:JANE
Last Name:SAWYER
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 1:7740C STENTON AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-3147
Mailing Address - Country:US
Mailing Address - Phone:215-595-7990
Mailing Address - Fax:
Practice Address - Street 1:550 PINETOWN RD STE 430
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2609
Practice Address - Country:US
Practice Address - Phone:610-615-0531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016135101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health