Provider Demographics
NPI:1053732909
Name:SANTRY, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SANTRY
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 1:301 HEIGHTS LN
Mailing Address - Street 2:APT 25F
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-7610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2005 CABOT BLVD W
Practice Address - Street 2:SUITE 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1885
Practice Address - Country:US
Practice Address - Phone:267-587-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-19
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health