Provider Demographics
NPI:1184249807
Name:LANDENBERGER, EMILY RYAN
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RYAN
Last Name:LANDENBERGER
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 1:2695 BRIDGEWATCH LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7731
Mailing Address - Country:US
Mailing Address - Phone:614-800-5050
Mailing Address - Fax:
Practice Address - Street 1:2695 BRIDGEWATCH LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7731
Practice Address - Country:US
Practice Address - Phone:614-800-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator