Healthcare Provider Details

I. General information

NPI: 1306787718
Provider Name (Legal Business Name): EMMA HOLLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

1007 N 2ND ST
IRONTON OH
45638-1235
US

IV. Provider business mailing address

PO BOX 614
IRONTON OH
45638-0614
US

V. Phone/Fax

Practice location:
  • Phone: 740-442-7045
  • Fax: 740-442-7047
Mailing address:
  • Phone: 740-442-7045
  • Fax: 740-442-7047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: