Individual
NICOLE VENTZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(701) 540-0442
Mailing address
891 BELSLY BLVD, MOORHEAD, MN 56560-5055
(218) 287-4338
(701) 540-0442
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/17/2015
Last updated
01/16/2018
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