Provider Demographics
NPI:1669045118
Name:CREAMER, EMMA (BCBA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:CREAMER
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 1:2075 BENTLEY PLZ
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2123
Mailing Address - Country:US
Mailing Address - Phone:844-743-6506
Mailing Address - Fax:
Practice Address - Street 1:2075 BENTLEY PLZ
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2123
Practice Address - Country:US
Practice Address - Phone:844-743-6506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MO2022006924103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician