Individual
MISS NICOLE MARIE LEVERNIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA, LBA
Contact information
Practice address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 960-7474
Mailing address
220 W GEORGIA AVE, NAMPA, ID 83686-2835
(208) 960-7474
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA61047548
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-20-40808
BOARD CERTIFIED BEHAVIOR ANALYST (BCBA)
—
Enumeration date
01/28/2017
Last updated
12/20/2021
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