Healthcare Provider Details

I. General information

NPI: 1235421082
Provider Name (Legal Business Name): EMILIE MCHANEY BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS EMILIE ZIEGLER

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COUNTY ROAD 423A
LORENA TX
76655-4351
US

IV. Provider business mailing address

111 COUNTY ROAD 423A
LORENA TX
76655-4351
US

V. Phone/Fax

Practice location:
  • Phone: 469-222-2442
  • Fax:
Mailing address:
  • Phone: 469-222-2442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: