Healthcare Provider Details

I. General information

NPI: 1669045118
Provider Name (Legal Business Name): EMMA MUNN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA CREAMER BCBA

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S EWING AVE
SAINT LOUIS MO
63103-2901
US

IV. Provider business mailing address

8409 CRAIGHILL DR
SAINT LOUIS MO
63123-2241
US

V. Phone/Fax

Practice location:
  • Phone: 314-228-0753
  • Fax:
Mailing address:
  • Phone: 314-541-4567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2022006924
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: