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NPI Code Detail

MEDICARE: SAMANTHA NICOLE EMERSON I

MEDICARE: SAMANTHA NICOLE EMERSON I
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 Technician

General Provider Information

NPI Number : 1851234090
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA NICOLE EMERSON I
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY STE 30
Second Line :
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 989-401-2244
Fax Number :
Provider Business Practice Location Address
First Line : 28241 MOUND RD STE C
Second Line :
City : WARREN
State : MI
Zip : 48092-5523
Country : US
Telephone Number : 989-401-2244
Fax Number : 989-401-2244
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ SAMANTHA NICOLE EMERSON I ” Practice Location

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