Individual
NITASHA RAE DICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, PLMHP
Contact information
Practice address
329 18TH ST APT 2L, BROOKLYN, NY 11215-6114
(402) 490-6983
Mailing address
329 18TH ST APT 2L, BROOKLYN, NY 11215-6114
(402) 490-6983
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9649
NE
103K00000X
Behavior Analyst
Primary
000509
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025287200
—
NE
Enumeration date
07/23/2012
Last updated
01/21/2021
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