Provider Demographics
NPI:1649813460
Name:GAULDIN, EMILY BEV (BCBA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:BEV
Last Name:GAULDIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3960 W MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6233
Mailing Address - Country:US
Mailing Address - Phone:479-713-0036
Mailing Address - Fax:479-927-4101
Practice Address - Street 1:6836 ISAACS ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6096
Practice Address - Country:US
Practice Address - Phone:479-927-4100
Practice Address - Fax:479-927-4101
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-24
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1-19-37969103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst