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NPI Code Detail

MEDICARE: EMILY LYNN NOVAK

MEDICARE: EMILY LYNN NOVAK
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 Analyst7401003209MI

General Provider Information

NPI Number : 1295685642
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY LYNN NOVAK
Provider Business Mailing Address
First Line : 20421 SUNNYDALE ST
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48081-3452
Country : US
Telephone Number : 586-863-3060
Fax Number :
Provider Business Practice Location Address
First Line : 44225 W TWELVE MILE RD STE C-106
Second Line :
City : NOVI
State : MI
Zip : 48377-2640
Country : US
Telephone Number : 248-277-3005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2026
Last Update Date : 02/03/2026

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1215457197 — ALAINA KRISTINE HAMILTON
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Practice Location Address:
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1689196552 — KELSI MICHELLE ANDREWS BCBA
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Directions to “ EMILY LYNN NOVAK ” Practice Location

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