Individual
EMILY ROSE BOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
4000 SMITHTOWN RD STE 200, SUWANEE, GA 30024-6560
(470) 632-4990
(317) 520-8200
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35273
GA
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
04/05/2019
Last updated
08/24/2020
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