Provider Demographics
NPI:1225278237
Name:SKIRVIN, EMERALD LEA (MA)
Entity Type:Individual
Prefix:
First Name:EMERALD
Middle Name:LEA
Last Name:SKIRVIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8529 NORTHPORT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3205
Mailing Address - Country:US
Mailing Address - Phone:513-374-9885
Mailing Address - Fax:
Practice Address - Street 1:2734 CHANCELLOR DR
Practice Address - Street 2:SUITE 203
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3487
Practice Address - Country:US
Practice Address - Phone:859-431-6333
Practice Address - Fax:859-341-0310
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist