Provider Demographics
NPI:1942664966
Name:STONEBURG, EMILEE RACHELLE (MED, BCBA, LBA-TN)
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:RACHELLE
Last Name:STONEBURG
Suffix:
Gender:F
Credentials:MED, BCBA, LBA-TN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12393
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28220-2393
Mailing Address - Country:US
Mailing Address - Phone:321-363-2219
Mailing Address - Fax:
Practice Address - Street 1:4012 PARK RD STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2377
Practice Address - Country:US
Practice Address - Phone:704-541-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst