Healthcare Provider Details

I. General information

NPI: 1780218602
Provider Name (Legal Business Name): EMILY KIGHT CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2020
Last Update Date: 02/29/2020
Certification Date: 02/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5945 SAWMILL RD UNIT B
DUBLIN OH
43017-1623
US

IV. Provider business mailing address

5945 SAWMILL RD UNIT B
DUBLIN OH
43017-1623
US

V. Phone/Fax

Practice location:
  • Phone: 614-389-3030
  • Fax: 614-413-3536
Mailing address:
  • Phone: 614-389-3030
  • Fax: 614-413-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.172947
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: