Healthcare Provider Details

I. General information

NPI: 1508773409
Provider Name (Legal Business Name): MS. EMMA BLANTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8411 BROADWAY AVE
CLEVELAND OH
44105-3932
US

IV. Provider business mailing address

8411 BROADWAY AVE
CLEVELAND OH
44105-3932
US

V. Phone/Fax

Practice location:
  • Phone: 216-441-0200
  • Fax: 216-441-3637
Mailing address:
  • Phone: 216-441-0200
  • Fax: 216-441-3637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: