Healthcare Provider Details

I. General information

NPI: 1881525178
Provider Name (Legal Business Name): EMMETT EMERY SR. ABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34212 JASPER STONE DR
WESLEY CHAPEL FL
33543-7293
US

IV. Provider business mailing address

34212 JASPER STONE DR
WESLEY CHAPEL FL
33543-7293
US

V. Phone/Fax

Practice location:
  • Phone: 813-495-7409
  • Fax:
Mailing address:
  • Phone: 813-495-7409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1216817
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: