Healthcare Provider Details

I. General information

NPI: 1376056606
Provider Name (Legal Business Name): EMILY MARGARET CORMACK M.ED, BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILY MARGARET MURPHY M.ED, BCBA, LABA

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 LINCOLN ST STE 201
WORCESTER MA
01605-3646
US

IV. Provider business mailing address

27 TERESA DR
HOLDEN MA
01520-2000
US

V. Phone/Fax

Practice location:
  • Phone: 774-206-1125
  • Fax:
Mailing address:
  • Phone: 508-341-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number3391
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: