Basic Information
| Provider Information | |||||||||
| NPI: | 1821746546 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMILEY | ||||||||
| FirstName: | EMMA | ||||||||
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| Credential: | RBT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1161 LAKE COOK RD | ||||||||
| Address2: | |||||||||
| City: | DEERFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600155649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474985437 | ||||||||
| FaxNumber: | 3128932118 | ||||||||
| Practice Location | |||||||||
| Address1: | 3113 W BELTLINE HWY STE 300 | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537132934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6088916810 | ||||||||
| FaxNumber: | 3128932118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2022 | ||||||||
| LastUpdateDate: | 03/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | RBT-22-206557 | WI | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.