Provider Demographics
NPI:1851413041
Name:ZALLEN, EMILY RACHEL
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RACHEL
Last Name:ZALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RACHEL
Other - Last Name:ZALLEN-SEVETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7616 CURRELL BLVD SUITE 110
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:651-259-9769
Mailing Address - Fax:651-259-9770
Practice Address - Street 1:7616 CURRELL BLVD SUITE 110
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-259-9760
Practice Address - Fax:651-259-9770
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical