Provider Demographics
NPI:1427562578
Name:GREST, EMILY WILKINSON (BCBA)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:WILKINSON
Last Name:GREST
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 PHOSPHOR AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2727
Mailing Address - Country:US
Mailing Address - Phone:504-229-2499
Mailing Address - Fax:
Practice Address - Street 1:718 PHOSPHOR AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2727
Practice Address - Country:US
Practice Address - Phone:504-229-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-28
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-19-36631103K00000X
LAL-389103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst