Provider Demographics
NPI:1275198160
Name:FILSON, EMILY KATHERINE (RBT)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:KATHERINE
Last Name:FILSON
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 1:922 W ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-2106
Mailing Address - Country:US
Mailing Address - Phone:602-301-2199
Mailing Address - Fax:
Practice Address - Street 1:4150 W PEORIA AVE STE 125
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3952
Practice Address - Country:US
Practice Address - Phone:602-288-8883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-17-44938106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician