Individual
NICHOLE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2236 BLACKWOOD DR, MULBERRY, FL 33860-5500
(863) 258-4147
Mailing address
2236 BLACKWOOD DR, MULBERRY, FL 33860-5500
(863) 258-4147
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-20-139659
FL
372600000X
Adult Companion
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
10/15/2020
Last updated
12/29/2021
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