Provider Demographics
NPI:1306322565
Name:MURRAY, EMILY JEAN (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JEAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:JEAN
Other - Last Name:BOARDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:57 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1826
Mailing Address - Country:US
Mailing Address - Phone:860-462-6128
Mailing Address - Fax:
Practice Address - Street 1:57 MADISON AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1826
Practice Address - Country:US
Practice Address - Phone:860-462-6128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-23431OtherBEHAVIOR ANALYST CERTIFICATION BOARD