Basic Information
Provider Information
NPI: 1174186332
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLANZ
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8227 BRECKSVILLE RD STE 104
Address2:  
City: BRECKSVILLE
State: OH
PostalCode: 441411363
CountryCode: US
TelephoneNumber: 4405260468
FaxNumber: 4405260454
Practice Location
Address1: 8227 BRECKSVILLE RD STE 104
Address2:  
City: BRECKSVILLE
State: OH
PostalCode: 441411363
CountryCode: US
TelephoneNumber: 4405260468
FaxNumber: 4405260454
Other Information
ProviderEnumerationDate: 04/15/2019
LastUpdateDate: 04/15/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XS.1701799OHY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home