Individual
LAURIE NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2253 24TH ST APT 1, ASTORIA, NY 11105-3412
(347) 624-4425
Mailing address
2253 24TH ST APT 1, ASTORIA, NY 11105-3412
(347) 624-4425
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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