Healthcare Provider Details

I. General information

NPI: 1285552224
Provider Name (Legal Business Name): EMILY LOUISE TIPTON MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 PRINCESS DR
BOISE ID
83716-8705
US

IV. Provider business mailing address

5405 PRINCESS DR
BOISE ID
83716-8705
US

V. Phone/Fax

Practice location:
  • Phone: 208-283-2020
  • Fax:
Mailing address:
  • Phone: 208-283-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88734
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: