Individual
EMILY KAITLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3730 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3424
(574) 387-4313
(574) 204-2868
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
(317) 802-7447
(574) 204-2868
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67821
MI
Other
Enumeration date
09/11/2023
Last updated
02/29/2024
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