Individual
MR. BEN NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBA
Contact information
Practice address
302 BARKER DR, MONROE, LA 71203-6544
(318) 243-6962
Mailing address
302 BARKER DR, MONROE, LA 71203-6544
(318) 243-6962
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L-063
LA
Other
Enumeration date
08/11/2014
Last updated
08/21/2014
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