Provider Demographics
NPI:1972069144
Name:GETIC, EMMA (BCBA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:GETIC
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 1:2391 NE INTERSTATE 410 LOOP
Mailing Address - Street 2:SUITE #304
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:210-228-9923
Mailing Address - Fax:
Practice Address - Street 1:2391 NE INTERSTATE 410 LOOP
Practice Address - Street 2:SUITE #304
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217
Practice Address - Country:US
Practice Address - Phone:210-228-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-18-69229106S00000X
TX1-20-45510103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician