Individual
IVY MARIE NICHOLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2600 PEACHTREE RD NW STE 2200, ATLANTA, GA 30305-3687
(855) 832-6727
Mailing address
2600 PEACHTREE RD NW STE 2200, ATLANTA, GA 30305-3687
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-149720
GA
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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