Individual
NICHOLAS ANTHONY MINEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1272 VIRGIL LANGFORD RD STE 101, WATKINSVILLE, GA 30677-7245
(706) 449-0273
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60847
GA
106S00000X
Behavior Technician
RBT-20-121895
GA
Other
Enumeration date
08/05/2020
Last updated
08/11/2022
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