Provider Demographics
NPI:1386260206
Name:GUZMAN, EMMA KATHERINE (MA)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:KATHERINE
Last Name:GUZMAN
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-8103
Mailing Address - Country:US
Mailing Address - Phone:224-407-7485
Mailing Address - Fax:
Practice Address - Street 1:284 BROAD ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-8103
Practice Address - Country:US
Practice Address - Phone:224-407-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10002353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health