Individual
ALEXANDER NICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1050 CONNECTICUT AVE NW STE 500, WASHINGTON, DC 20036-5304
(833) 599-2560
Mailing address
850 TOWBIN AVE, LAKEWOOD, NJ 08701-5928
(732) 515-3709
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-192574
RBT CERTIFIICATION
—
Enumeration date
11/23/2021
Last updated
11/23/2021
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