Individual
NICOLE MOES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
5521 W LINCOLN HWY STE 101, CROWN POINT, IN 46307-1118
(219) 359-3272
(219) 359-3089
Mailing address
114 PLUM CREEK DR APT 2N, SCHERERVILLE, IN 46375-1133
(219) 218-8009
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-53013
IN
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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