Provider Demographics
NPI:1629470653
Name:HARRISON, EMILY (BCBA)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4608 BENNETT AVE
Mailing Address - Street 2:104
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3300
Mailing Address - Country:US
Mailing Address - Phone:404-374-3436
Mailing Address - Fax:
Practice Address - Street 1:1900 CYPRESS CREEK RD
Practice Address - Street 2:101
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3513
Practice Address - Country:US
Practice Address - Phone:512-996-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-16336103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst