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General NPI Number Information
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NPI Number | 1609426535
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Entity Type | Individual
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Provider Name | EMILY SMITH MA, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 3178 HILTON RD
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City | FERNDALE
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State | MI
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Zip | 48220-1059
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Country | US
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Telephone | 248-692-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 51275 VILLAGE EDGE E APT 108
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City | CHESTERFIELD
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State | MI
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Zip | 48047-1323
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Country | US
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Telephone | 248-762-1636
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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 | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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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 | 7401002521
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License Number State | MI
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