Provider Demographics
NPI:1790433969
Name:HALE, EMILY (BCBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13051 JENNA CT
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8020
Mailing Address - Country:US
Mailing Address - Phone:317-941-0077
Mailing Address - Fax:
Practice Address - Street 1:13051 JENNA CT
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8020
Practice Address - Country:US
Practice Address - Phone:317-941-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician