Individual
MR. NICHOLAS DAVID RESTIFO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3090 MAPLE DR, PRIOR LAKE, MN 55372-2841
(651) 295-9308
Mailing address
3090 MAPLE DR, PRIOR LAKE, MN 55372-2841
(651) 295-9308
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/29/2020
Last updated
09/29/2020
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