=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013873363
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. EMILIE FARRELL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2025
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 230 ROUTE 206
-----------------------------------------------------
City | FLANDERS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07836-9189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-562-9411
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34 TIMBERLINE RD
-----------------------------------------------------
City | BUDD LAKE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07828-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-222-1899
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------