Provider Demographics
NPI:1306601075
Name:MARPLE, EMMA LILIUOKALANI ELEOLA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LILIUOKALANI ELEOLA
Last Name:MARPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 W UNIVERSITY AVE UNIT 1122
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6167
Mailing Address - Country:US
Mailing Address - Phone:808-306-9047
Mailing Address - Fax:
Practice Address - Street 1:8501 W UNIVERSITY AVE UNIT 1122
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6167
Practice Address - Country:US
Practice Address - Phone:808-306-9047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT4100106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician