Individual
MRS. NICOLE MINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
18697 FOREST RD, LYNCHBURG, VA 24502-4363
(434) 239-0003
Mailing address
18697 FOREST RD, LYNCHBURG, VA 24502-4363
(434) 239-0003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000348
VA
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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