Provider Demographics
NPI:1306229315
Name:TARJEFT, EMILY ELIZABETH
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:TARJEFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:MEISSNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12378 VOLPE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-5328
Mailing Address - Country:US
Mailing Address - Phone:734-925-1504
Mailing Address - Fax:
Practice Address - Street 1:30301 NORTHWESTERN HWY STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3277
Practice Address - Country:US
Practice Address - Phone:248-554-6358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301018313103T00000X
MI6301017447103TC0700X
246Z00000X
MI6361003885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other