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NPI Code Detail

MEDICARE: MRS. EMILY CORNELL MA, BCBA

MEDICARE: MRS. EMILY CORNELL MA, 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 Analyst

General Provider Information

NPI Number : 1972171643
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY CORNELL MA, BCBA
Provider Business Mailing Address
First Line : 2612 W LAMBERTH RD STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75092-5181
Country : US
Telephone Number : 903-647-8214
Fax Number :
Provider Business Practice Location Address
First Line : 2612 W LAMBERTH RD STE 100
Second Line :
City : SHERMAN
State : TX
Zip : 75092-5181
Country : US
Telephone Number : 903-647-8214
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2021
Last Update Date : 11/01/2024

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