Provider Demographics
NPI:1790271005
Name:YEARYEAN, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:YEARYEAN
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 1:5982 RHODES RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-8100
Mailing Address - Country:US
Mailing Address - Phone:330-676-1347
Mailing Address - Fax:330-678-3677
Practice Address - Street 1:9537 CLOVERLEAF RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:OH
Practice Address - Zip Code:44288-1176
Practice Address - Country:US
Practice Address - Phone:330-326-3404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator