Individual
NICOLE RAYNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3311 CANDELARIA RD NE STE 3311-A, ALBUQUERQUE, NM 87107-1959
(818) 241-6780
(800) 819-7806
Mailing address
PO BOX 746075, ATLANTA, GA 30374-6075
(818) 241-6780
(800) 819-7806
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-46942
CO
Other
Enumeration date
01/14/2021
Last updated
02/21/2023
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