Provider Demographics
NPI:1114588993
Name:VICCARONE, EMILY JANEEN (BCBA, COBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JANEEN
Last Name:VICCARONE
Suffix:
Gender:F
Credentials:BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12541 CARIBOU CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9358
Mailing Address - Country:US
Mailing Address - Phone:440-458-0097
Mailing Address - Fax:
Practice Address - Street 1:27991 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3902
Practice Address - Country:US
Practice Address - Phone:440-455-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst