Individual
NICOLE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
197 RIDGE POINT DR, CONWAY, SC 29526-1203
(631) 839-8226
Mailing address
197 RIDGE POINT DR, CONWAY, SC 29526-1203
(631) 839-8226
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42606
SC
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/25/2018
Last updated
06/16/2020
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