Provider Demographics
NPI:1699049882
Name:ACCROCCO, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ACCROCCO
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 1:253 MAIN ST
Mailing Address - Street 2:#1
Mailing Address - City:WEST DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02670-2260
Mailing Address - Country:US
Mailing Address - Phone:828-551-2094
Mailing Address - Fax:
Practice Address - Street 1:253 MAIN ST
Practice Address - Street 2:#1
Practice Address - City:WEST DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02670-2260
Practice Address - Country:US
Practice Address - Phone:828-551-2094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health