Basic Information
Provider Information
NPI: 1699396028
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKLE
FirstName: EMMA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 E CHURCH ST
Address2:  
City: LIGONIER
State: PA
PostalCode: 156581411
CountryCode: US
TelephoneNumber: 7247081331
FaxNumber:  
Practice Location
Address1: 1100 RIDGEFIELD BLVD STE 190
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288066211
CountryCode: US
TelephoneNumber: 8286707723
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/27/2020
LastUpdateDate: 04/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103K00000X1-19-40395PAY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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