Provider Demographics
NPI:1124543301
Name:CLOUSE, EMILY RENEE (RBT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RENEE
Last Name:CLOUSE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UW AUTISM CENTER - TACOMA
Mailing Address - Street 2:BOX 358455 1900 COMMERCE ST. MDS-110
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3112
Practice Address - Country:US
Practice Address - Phone:253-692-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician