Provider Demographics
NPI:1386306918
Name:ZIEGLER, EMILY GRACE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:ZIEGLER
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 1:1965 W VERNEAL LN
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6581
Mailing Address - Country:US
Mailing Address - Phone:208-901-0533
Mailing Address - Fax:
Practice Address - Street 1:4477 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-2000
Practice Address - Country:US
Practice Address - Phone:208-901-0533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2025-08-19
Deactivation Date:2025-07-21
Deactivation Code:
Reactivation Date:2025-08-13
Provider Licenses
StateLicense IDTaxonomies
ID1471765101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health