Individual
HOLLAND NICOLE WHEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
5452 CONGRESS AVE APT 1, MADISON, WI 53718-2233
(509) 954-0422
Mailing address
2008 173RD ST SE, BOTHELL, WA 98012-6466
(509) 954-0422
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79499
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/05/2021
Last updated
02/25/2025
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