Provider Demographics
NPI:1861746729
Name:RADEMAN, EMILY (PSYD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:RADEMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 SPRING MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-1140
Mailing Address - Country:US
Mailing Address - Phone:719-357-6462
Mailing Address - Fax:719-203-4485
Practice Address - Street 1:156 SPRING MEADOW DR
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-1140
Practice Address - Country:US
Practice Address - Phone:719-357-6462
Practice Address - Fax:719-203-4485
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004289103TC0700X
MO2012037392101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional