Basic Information
Provider Information
NPI: 1861109845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OLEE
FirstName: EMMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1700 GOODYEAR BLVD
Address2:  
City: AKRON
State: OH
PostalCode: 443053528
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 340 S BROADWAY ST
Address2:  
City: AKRON
State: OH
PostalCode: 443081529
CountryCode: US
TelephoneNumber: 3302533100
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/31/2022
LastUpdateDate: 10/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XC.2204578OHY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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