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NPI Code Detail

MEDICARE: EMILY CARLSON BCBA

MEDICARE: EMILY CARLSON 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
1106S00000XBehavior TechnicianRBT-17-36493MD
2103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11659897262OTHERNPI

General Provider Information

NPI Number : 1659897262
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY CARLSON BCBA
Provider Business Mailing Address
First Line : 1651 CROFTON BLVD
Second Line :
City : CROFTON
State : MD
Zip : 21114-1314
Country : US
Telephone Number : 443-302-2420
Fax Number :
Provider Business Practice Location Address
First Line : 1651 CROFTON BLVD
Second Line :
City : CROFTON
State : MD
Zip : 21114-1314
Country : US
Telephone Number : 443-302-2420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2017
Last Update Date : 06/03/2021

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