Provider Demographics
NPI:1508015900
Name:DILLER, EMMALY ESTHER (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:EMMALY
Middle Name:ESTHER
Last Name:DILLER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-9257
Mailing Address - Country:US
Mailing Address - Phone:937-689-0973
Mailing Address - Fax:
Practice Address - Street 1:1125 RAINTREE DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-9257
Practice Address - Country:US
Practice Address - Phone:937-689-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.19018711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI.1901871OtherOHIO STATE LICENSING BOARD