Provider Demographics
NPI:1033967526
Name:EMERGENT LEARNING LLC
Entity type:Organization
Organization Name:EMERGENT LEARNING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA-D
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-275-0506
Mailing Address - Street 1:1305 N H ST, STE A #144
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436
Mailing Address - Country:US
Mailing Address - Phone:314-275-0506
Mailing Address - Fax:314-463-4937
Practice Address - Street 1:11780 BORMAN DR STE 400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4135
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:314-463-4937
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMERGENT LEARNING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty