Healthcare Provider Details
I. General information
NPI: 1417781279
Provider Name (Legal Business Name): EMMA FIUME
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/26/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
773 BROOKSEDGE BLVD
WESTERVILLE OH
43081-2821
US
IV. Provider business mailing address
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS IN
46268-6135
US
V. Phone/Fax
- Phone: 614-401-3366
- Fax: 317-520-8200
- Phone: 855-324-0885
- Fax: 317-520-8200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | RBT-24-355438 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: