Healthcare Provider Details

I. General information

NPI: 1093634917
Provider Name (Legal Business Name): EMMA LUCILLE LOVELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 ALEXA DR
MOUNT STERLING KY
40353-1000
US

IV. Provider business mailing address

805 ALEXA DR
MOUNT STERLING KY
40353-1000
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-5664
  • Fax:
Mailing address:
  • Phone: 855-444-5664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2826061
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: