Individual
NICOLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
2105 E PARK ST, CEDAR PARK, TX 78613-4598
(512) 986-7335
Mailing address
2105 E PARK ST, CEDAR PARK, TX 78613-4598
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
TX
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
03/18/2015
Last updated
11/05/2020
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