Healthcare Provider Details

I. General information

NPI: 1497976187
Provider Name (Legal Business Name): EMILY HOLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 LAKE FOREST PKWY
LOUISVILLE KY
40245
US

IV. Provider business mailing address

934 LAKE FOREST PKWY
LOUISVILLE KY
40245-5181
US

V. Phone/Fax

Practice location:
  • Phone: 502-445-9998
  • Fax:
Mailing address:
  • Phone: 502-445-9998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: