Provider Demographics
NPI:1588265060
Name:BRUNO, EMORY CHRISTINE (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:EMORY
Middle Name:CHRISTINE
Last Name:BRUNO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E CARY ST APT 127
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-6988
Mailing Address - Country:US
Mailing Address - Phone:757-439-4042
Mailing Address - Fax:
Practice Address - Street 1:10487 LAKERIDGE PKWY STE 450
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-8151
Practice Address - Country:US
Practice Address - Phone:804-557-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001829103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst