Provider Demographics
NPI:1265061287
Name:JARVI, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:JARVI
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 1:27600 CHAGRIN BLVD STE 475
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4421
Mailing Address - Country:US
Mailing Address - Phone:216-508-4050
Mailing Address - Fax:216-446-0171
Practice Address - Street 1:27600 CHAGRIN BLVD STE 475
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4421
Practice Address - Country:US
Practice Address - Phone:216-508-4050
Practice Address - Fax:216-446-0171
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41051103K00000X
OHCOBA.00671103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCOBA.00671OtherCOBA NUMBER
1-20-41051OtherBCBA NUMBER