Provider Demographics
NPI:1124496138
Name:EIMON, MICHELE (MS, NCC)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:EIMON
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 WILLIAMSTOWNE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2322
Mailing Address - Country:US
Mailing Address - Phone:262-443-4301
Mailing Address - Fax:
Practice Address - Street 1:394 WILLIAMSTOWNE
Practice Address - Street 2:SUITE 10
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2322
Practice Address - Country:US
Practice Address - Phone:262-443-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2027-226101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor