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General NPI Number Information
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NPI Number | 1114529310
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Entity Type | Individual
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Provider Name | EMILY JO BAKER BCABA
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Gender | Female
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | 8000 TOWERS CRESCENT DR FL 13
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City | VIENNA
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State | VA
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Zip | 22182-6211
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Country | US
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Telephone | 833-599-2560
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Fax |
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Provider Business Mailing Address
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Address Line | 1249 HAMILTON AVE SW
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City | ROANOKE
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State | VA
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Zip | 24015-1738
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Country | US
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Telephone | 540-520-1939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0134000343
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133003228
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License Number State | VA
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