Doctor Name: | EMILY CUSTER |
NPI Number: | 1225435969 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | C1300470 |
Business Practice Address: | 3737 Lander Rd Pepper Pike, OH - 441245712 |
Business Phone Number: | 2168312255 |
Business Fax Number: | |
Mailing Address: | 3737 Lander Rd, PEPPER PIKE |
State: | OH |
Postal Code: | 441245712 |
Phone Number: | 2168312255 |
Fax Number: | |
NPI Enumeration Date: | 11/24/2014 |
NPI Last Update Date: | 11/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | C1300470 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |