Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 1701202 | OH |
NPI | 1003326547 |
---|---|
Provider Name | Emily Renae Ly |
First Address | Cincinnati, OH 45212-1704 |
Second Address | Cincinnati, OH 45227-1491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2017 |
Last Update Date | 16/10/2018 |