Provider Demographics
NPI:1497472948
Name:PELKEY, EMILY SUZANNE (LCAT-LP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SUZANNE
Last Name:PELKEY
Suffix:
Gender:F
Credentials:LCAT-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WINDSORSHIRE DR APT C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1211
Mailing Address - Country:US
Mailing Address - Phone:315-323-1824
Mailing Address - Fax:
Practice Address - Street 1:1163 PITTSFORD VICTOR RD STE 150
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3834
Practice Address - Country:US
Practice Address - Phone:585-430-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP118560221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist