Provider Demographics
NPI:1174192199
Name:WATTS, EMILY (ASST BEHAVIOR ANALYS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:ASST BEHAVIOR ANALYS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:PERGOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:583 SHOEMAKER RD STE 230
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4238
Mailing Address - Country:US
Mailing Address - Phone:484-681-2170
Mailing Address - Fax:
Practice Address - Street 1:583 SHOEMAKER RD STE 230
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4238
Practice Address - Country:US
Practice Address - Phone:484-681-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-163052106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician