Provider Demographics
NPI:1902276314
Name:TOTH, EMILY LOUISE (BCBA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:LOUISE
Last Name:TOTH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:LOUISE
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3500 DEPAUW BOULEVARD
Mailing Address - Street 2:SUITE 3070
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-6135
Mailing Address - Country:US
Mailing Address - Phone:855-324-0885
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:335 W 84TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6245
Practice Address - Country:US
Practice Address - Phone:219-205-3463
Practice Address - Fax:765-450-6664
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-15-17995103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-15-17995OtherBCBA BOARD CERTIFICATION