Individual
NICKAYLA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 COMPUTER DR W STE 210, ALBANY, NY 12205-1622
(888) 805-0759
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/08/2019
Last updated
10/08/2019
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