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Individual
NICOLE ELLISH
Active
Individual
NICOLE ELLISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11725028
IL
103K00000X
Behavior Analyst
176-140
WI
Other
Enumeration date
04/05/2017
Last updated
10/03/2020
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