Provider Demographics
NPI:1093435059
Name:CARR, EMILEE NIKOLE (RBT)
Entity type:Individual
Prefix:
First Name:EMILEE
Middle Name:NIKOLE
Last Name:CARR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:EMILEE
Other - Middle Name:NIKOLE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:2821 TEXAS ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-3924
Mailing Address - Country:US
Mailing Address - Phone:469-866-2484
Mailing Address - Fax:
Practice Address - Street 1:709 W BROAD ST
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-9148
Practice Address - Country:US
Practice Address - Phone:469-458-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-231548106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician