Provider Demographics
NPI:1699804112
Name:OANDASAN, EMILY SUMIKO (MA EDUCATION, COUN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:SUMIKO
Last Name:OANDASAN
Suffix:
Gender:F
Credentials:MA EDUCATION, COUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 S MAPLE AVE APT 1084
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3635
Mailing Address - Country:US
Mailing Address - Phone:310-528-4306
Mailing Address - Fax:602-271-3497
Practice Address - Street 1:6445 S MAPLE AVE APT 1084
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3635
Practice Address - Country:US
Practice Address - Phone:310-528-4306
Practice Address - Fax:602-271-3497
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18878101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool