Individual
NICOLE SMOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
55 EMS T6 LN, LEESBURG, IN 46538-9423
(574) 387-4313
Mailing address
55 EMS T6 LN, LEESBURG, IN 46538-9423
(574) 387-4313
(574) 204-2868
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-26586
IN
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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