Individual
NICOLE MARIE POPOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(574) 289-4831
(574) 289-4831
Mailing address
2505 E JEFFERSON BLVD, SOUTH BEND, IN 46615-2635
(630) 877-7748
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62320
FL
103K00000X
Behavior Analyst
Primary
1-22-62320
IN
106S00000X
Behavior Technician
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Other
Enumeration date
09/01/2021
Last updated
01/26/2026
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