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NPI Code Detail

MEDICARE: EMILY FAITH PHILIP

MEDICARE: EMILY FAITH PHILIP
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 Analyst12690417AR

General Provider Information

NPI Number : 1972486892
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY FAITH PHILIP
Provider Business Mailing Address
First Line : 2717 ELLIOTT ST
Second Line :
City : PEA RIDGE
State : AR
Zip : 72751
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3400 N WOODS LN
Second Line :
City : ROGERS
State : AR
Zip : 72756-6712
Country : US
Telephone Number : 479-636-3190
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2025
Last Update Date : 06/05/2026

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Directions to “ EMILY FAITH PHILIP ” Practice Location

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