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NPI Code Detail

MEDICARE: EMILY SIEWERT

MEDICARE: EMILY SIEWERT
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205488368
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY SIEWERT
Provider Business Mailing Address
First Line : 300 INTERNATIONAL PKWY STE 200
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-5028
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 5220 LEE BLVD
Second Line :
City : LEHIGH ACRES
State : FL
Zip : 33971-1036
Country : US
Telephone Number : 239-288-0548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 07/09/2019

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Directions to “ EMILY SIEWERT ” Practice Location

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