Healthcare Provider Details

I. General information

NPI: 1164162194
Provider Name (Legal Business Name): EMILY MARIE TOICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 MIDWAY BLVD STE 210
ELYRIA OH
44035-2496
US

IV. Provider business mailing address

737 CAROL LN
ELYRIA OH
44035-8259
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-5555
  • Fax:
Mailing address:
  • Phone: 440-864-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-22-209312
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: