Healthcare Provider Details

I. General information

NPI: 1952185589
Provider Name (Legal Business Name): EMMA GRACE MACCUISH MS, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 E 59TH ST
KANSAS CITY MO
64113-2116
US

IV. Provider business mailing address

2 E 59TH ST
KANSAS CITY MO
64113-2116
US

V. Phone/Fax

Practice location:
  • Phone: 816-866-5662
  • Fax: 816-817-0831
Mailing address:
  • Phone: 816-866-5662
  • Fax: 816-817-0831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86816
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: