Provider Demographics
NPI:1427787308
Name:NOTARIANNI, EMILIA GRACE
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:GRACE
Last Name:NOTARIANNI
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 1:16820 CHANDLER RD APT 1102
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5178
Mailing Address - Country:US
Mailing Address - Phone:248-376-6676
Mailing Address - Fax:
Practice Address - Street 1:620 FARM LN RM 213
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-1600
Practice Address - Country:US
Practice Address - Phone:517-884-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst