Provider Demographics
NPI:1720827355
Name:SLOAN, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SLOAN
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 1:168 STEWART RD
Mailing Address - Street 2:
Mailing Address - City:PILESGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-3223
Mailing Address - Country:US
Mailing Address - Phone:770-712-2876
Mailing Address - Fax:
Practice Address - Street 1:168 STEWART RD
Practice Address - Street 2:
Practice Address - City:PILESGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08098-3223
Practice Address - Country:US
Practice Address - Phone:770-712-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00644700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist