Individual
KATELYN ELIZABETH NICKLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
2035 S 4TH ST, PHILADELPHIA, PA 19148-2550
(724) 630-5785
Mailing address
306 N KENSINGTON AVE, LA GRANGE PARK, IL 60526-1870
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-37911
PA
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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