Healthcare Provider Details

I. General information

NPI: 1487236899
Provider Name (Legal Business Name): EMILY JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6877 N HIGH ST STE 305
WORTHINGTON OH
43085-2589
US

IV. Provider business mailing address

510 WILLEY RD
DELAWARE OH
43015-9724
US

V. Phone/Fax

Practice location:
  • Phone: 614-751-1090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE.2404450
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20263449-SP
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: