Provider Demographics
NPI:1194079798
Name:HENRICH, EMILY HOPE (DPT, OCS)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:HOPE
Last Name:HENRICH
Suffix:
Gender:F
Credentials:DPT, OCS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:PETSCHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 CLEVELAND AVE S
Mailing Address - Street 2:#K-6
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1930
Mailing Address - Country:US
Mailing Address - Phone:651-232-6852
Mailing Address - Fax:
Practice Address - Street 1:1825 WOODWINDS DR
Practice Address - Street 2:#100
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2202
Practice Address - Country:US
Practice Address - Phone:651-232-6852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-04
Last Update Date:2017-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist