Individual
TANISHA LOREN NOWICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LBA, BCBA
Contact information
Practice address
2730 S VAL VISTA DR STE 140, GILBERT, AZ 85295-1679
(480) 608-4640
Mailing address
2730 S VAL VISTA DR STE 140, GILBERT, AZ 85295-1679
(480) 608-4640
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-000493
AZ
Other
Enumeration date
09/26/2019
Last updated
11/07/2022
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