Individual
EMMA L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
100 INTREPID LN STE 2, SYRACUSE, NY 13205-2546
(315) 797-6241
(315) 749-7054
Mailing address
725 DAEDALIAN DR, ROME, NY 13441-4908
(315) 927-3904
(315) 749-7054
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
002502
NY
103K00000X
Behavior Analyst
Primary
1-22-62182
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-62182
CERTIFICATION
NM
Enumeration date
12/14/2022
Last updated
03/11/2024
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