Provider Demographics
NPI:1659081552
Name:ROZANSKI, EMILY (RBT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ROZANSKI
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 1:20 COURTHOUSE SQ
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3530
Mailing Address - Country:US
Mailing Address - Phone:423-805-9889
Mailing Address - Fax:423-805-9889
Practice Address - Street 1:20 COURTHOUSE SQ
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3530
Practice Address - Country:US
Practice Address - Phone:423-805-9889
Practice Address - Fax:423-805-9889
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-22-215300106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty