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NPI Code Detail

MEDICARE: EMILY S TREADWAY BCBA

MEDICARE: EMILY S TREADWAY BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1023435286
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY S TREADWAY BCBA
Provider Business Mailing Address
First Line : 2102 YORK BND
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-4414
Country : US
Telephone Number : 985-804-3384
Fax Number :
Provider Business Practice Location Address
First Line : 9314 RYDER DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78254-2000
Country : US
Telephone Number : 210-447-0039
Fax Number : 210-579-7100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2014
Last Update Date : 03/17/2018

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Directions to “ EMILY S TREADWAY BCBA” Practice Location

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