Provider Demographics
NPI:1376033902
Name:CRAMER, EMILY ELIZABETH (RBT-18-55952)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ELIZABETH
Last Name:CRAMER
Suffix:
Gender:F
Credentials:RBT-18-55952
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37522 FOUNTAIN PKWY APT 183
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-5607
Mailing Address - Country:US
Mailing Address - Phone:330-719-9264
Mailing Address - Fax:
Practice Address - Street 1:37522 FOUNTAIN PKWY APT 183
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5607
Practice Address - Country:US
Practice Address - Phone:330-719-9264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRBT-18-55952106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician