Individual provider Active NPI

Emma Jolie Wofford

  • Behavior Technician
  • Gilbert, AZ
National Provider Identifier
1265268577
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5656 S Power Rd Ste B121
Gilbert, AZ 85295-8480
Phone
(602) 610-4633
NPI assigned
Sep 12, 2024
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

5656 S Power Rd Ste B121
Gilbert, AZ 85295-8480

Mailing address

996 Royal Marco Way
Marco Island, FL 34145-1829

Other names 1

  • Max Jolie Wofford Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1265268577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 ROYAL MARCO WAY",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341451829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 S POWER RD STE B121",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852958480",
            "telephone_number": "602-610-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOFFORD",
        "first_name": "EMMA",
        "middle_name": "JOLIE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAX",
            "last_name": "WOFFORD",
            "middle_name": "JOLIE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.