Provider Demographics
NPI:1275419897
Name:SAMPSEL, EMMA (RBT-25-460300)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:SAMPSEL
Suffix:
Gender:F
Credentials:RBT-25-460300
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 E COUNTY ROAD 500 N
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-8635
Mailing Address - Country:US
Mailing Address - Phone:220-201-6058
Mailing Address - Fax:
Practice Address - Street 1:2701 ALBRIGHT RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3996
Practice Address - Country:US
Practice Address - Phone:765-438-8515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician