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NPI Code Detail

MEDICARE: EMILY DANIELLE REDDING BCBA

MEDICARE: EMILY DANIELLE REDDING BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-17-25705TX

General Provider Information

NPI Number : 1184156549
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DANIELLE REDDING BCBA
Provider Business Mailing Address
First Line : 1101 NW GOODYEAR BLVD
Second Line :
City : LAWTON
State : OK
Zip : 73505-9716
Country : US
Telephone Number : 940-473-9272
Fax Number :
Provider Business Practice Location Address
First Line : 3005 SW PARK AVE
Second Line :
City : LAWTON
State : OK
Zip : 73505-7902
Country : US
Telephone Number : 580-699-5558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2017
Last Update Date : 10/28/2020

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Directions to “ EMILY DANIELLE REDDING BCBA” Practice Location

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