Healthcare Provider Details

I. General information

NPI: 1881184166
Provider Name (Legal Business Name): EMMA QUINN BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2018
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22919 SAGEBRUSH
NOVI MI
48375-4167
US

IV. Provider business mailing address

22919 SAGEBRUSH
NOVI MI
48375-4167
US

V. Phone/Fax

Practice location:
  • Phone: 248-308-5966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401002318
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: