Individual
BRANDON NICHOLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBA
Contact information
Practice address
571 MORSE MEMORIAL HWY, OLMSTEDVILLE, NY 12857-1825
(607) 434-5134
Mailing address
571 MORSE MEMORIAL HWY, OLMSTEDVILLE, NY 12857-1825
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000559
NY
Other
Enumeration date
06/06/2018
Last updated
06/06/2018
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