Provider Demographics
NPI:1346843661
Name:KINLEY, EMILY PARRISH
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:PARRISH
Last Name:KINLEY
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 1:916 COX RD STE 201
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3496
Mailing Address - Country:US
Mailing Address - Phone:704-780-4271
Mailing Address - Fax:
Practice Address - Street 1:109 N DILLING ST
Practice Address - Street 2:
Practice Address - City:KINGS MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28086-3043
Practice Address - Country:US
Practice Address - Phone:704-675-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty