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Individual

NICOLE WILLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., BCBA, LBA

Contact information

Practice address
2248 MOUNT HOPE RD, OKEMOS, MI 48864-2501
(517) 604-8855
Mailing address
2248 MOUNT HOPE RD, OKEMOS, MI 48864-2501

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401001950
MI
106S00000X
Behavior Technician

Other

Enumeration date
10/05/2020
Last updated
03/07/2023
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