Provider Demographics
NPI:1235685678
Name:MCCOY, EMILY (CCC-SLP, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MCCOY
Suffix:
Gender:F
Credentials:CCC-SLP, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 VARGAS RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-3563
Mailing Address - Country:US
Mailing Address - Phone:713-377-2162
Mailing Address - Fax:512-904-7509
Practice Address - Street 1:1207 VARGAS RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-3563
Practice Address - Country:US
Practice Address - Phone:713-377-2162
Practice Address - Fax:512-904-7509
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3182103K00000X
TX110746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty