Healthcare Provider Details

I. General information

NPI: 1871145466
Provider Name (Legal Business Name): EMIL N MAJETICH JR. BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7215 WESTSHIRE DR
LANSING MI
48917-9764
US

IV. Provider business mailing address

319 WINSTON SALEM AVE
VIRGINIA BEACH VA
23451-3636
US

V. Phone/Fax

Practice location:
  • Phone: 517-657-2638
  • Fax: 248-711-2438
Mailing address:
  • Phone: 757-892-0559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002606
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: