Individual
TATIANA NICHOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1585 N MILWAUKEE AVE STE 101, LIBERTYVILLE, IL 60048-1359
(847) 918-7947
Mailing address
1585 N MILWAUKEE AVE STE 101, LIBERTYVILLE, IL 60048-1359
(847) 918-7947
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73162
IL
103K00000X
Behavior Analyst
152000658
IL
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
04/10/2019
Last updated
04/30/2025
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