Healthcare Provider Details

I. General information

NPI: 1962857276
Provider Name (Legal Business Name): EMILY ELIZABETH KELLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W MARKET ST
AKRON OH
44303-1411
US

IV. Provider business mailing address

674 ECTON RD
AKRON OH
44303-1611
US

V. Phone/Fax

Practice location:
  • Phone: 330-996-4600
  • Fax:
Mailing address:
  • Phone: 330-801-9241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: