Provider Demographics
NPI:1366110975
Name:NEWMAN, EMILIE (BCBA)
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:
Last Name:NEWMAN
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 1:1 DIAMOND CAUSEWAY, SUITE 21 - 121
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406
Mailing Address - Country:US
Mailing Address - Phone:912-434-4343
Mailing Address - Fax:912-452-9600
Practice Address - Street 1:1 DIAMOND CAUSEWAY, SUITE 21 - 121
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406
Practice Address - Country:US
Practice Address - Phone:912-434-4343
Practice Address - Fax:912-452-9600
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-20-42274OtherBCBA CERTIFICATION