Provider Demographics
NPI:1851029441
Name:KYLE, EMILY HOPE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:HOPE
Last Name:KYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:HOPE
Other - Last Name:BADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7427 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-6612
Mailing Address - Country:US
Mailing Address - Phone:330-635-2998
Mailing Address - Fax:
Practice Address - Street 1:5955 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-3936
Practice Address - Country:US
Practice Address - Phone:330-635-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204427101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC.2204427OtherLICENSED PROFESSIONAL COUNSELOR