Individual
EMILEY MIDYETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
112 BROWN ST, SANTA ROSA, CA 95404-5007
(707) 913-5627
Mailing address
112 BROWN ST, SANTA ROSA, CA 95404-5007
(707) 913-5627
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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