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NPI Code Detail

MEDICARE: SAVANNAH BAILEY EMMONS

MEDICARE: SAVANNAH BAILEY EMMONS
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
1106S00000XBehavior TechnicianRBT-21-185747IN

General Provider Information

NPI Number : 1215652573
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH BAILEY EMMONS
Provider Business Mailing Address
First Line : 8702 FOUNDERS RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1337
Country : US
Telephone Number : 317-900-1030
Fax Number :
Provider Business Practice Location Address
First Line : 8702 FOUNDERS RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1337
Country : US
Telephone Number : 317-900-1030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2022
Last Update Date : 10/10/2022

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Directions to “ SAVANNAH BAILEY EMMONS ” Practice Location

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