Individual
SUSAN JENNIFER NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
N27W23953 PAUL RD, SUITE 206, PEWAUKEE, WI 53072-6242
(262) 347-0701
(262) 347-0705
Mailing address
N27W23953 PAUL RD, SUITE 206, PEWAUKEE, WI 53072-6242
(262) 347-0701
(262) 347-0705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
82-140
WI
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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