MEDICARE: MOLLY EMOND BCBA, LBA

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
1	103K00000X	Behavior Analyst	306559	KY

General Provider Information

NPI Number	:	1174471874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY EMOND BCBA, LBA

Provider Business Mailing Address
First Line	:	3715 E HIGHWAY 452
Second Line	:
City	:	EUBANK
State	:	KY
Zip	:	42567-9731
Country	:	US
Telephone Number	:	606-802-4156
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 JAXSONS CV
Second Line	:
City	:	SOMERSET
State	:	KY
Zip	:	42503-5488
Country	:	US
Telephone Number	:	606-677-1166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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