MEDICARE: EMG CONSULTING LLC

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1508016791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMG CONSULTING LLC

Provider Business Mailing Address
First Line	:	700 DWYER RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6921
Country	:	US
Telephone Number	:	757-615-3003
Fax Number	:	800-858-1143

Provider Business Practice Location Address
First Line	:	700 DWYER RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-6921
Country	:	US
Telephone Number	:	757-615-3003
Fax Number	:	800-858-1143

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MS. ELIZABETH MARIE GILMORE
Credential	:	M.S. ED., BCBA
Telephone Number	:	757-615-3003

Provider Enumeration Date	:	09/24/2008
Last Update Date	:	10/05/2015

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