Healthcare Provider Details

I. General information

NPI: 1902276314
Provider Name (Legal Business Name): EMILY LOUISE TOTH BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY LOUISE PAYNE BCBA

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 W 84TH DR
MERRILLVILLE IN
46410-6245
US

IV. Provider business mailing address

3500 DEPAUW BOULEVARD SUITE 3070
INDIANAPOLIS IN
46268-6135
US

V. Phone/Fax

Practice location:
  • Phone: 219-205-3463
  • Fax: 765-450-6664
Mailing address:
  • Phone: 855-324-0885
  • Fax: 317-520-8200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-15-17995
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: