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Individual

NICOLE WEIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, BCBA, LBA

Contact information

Practice address
1375 AVON BLVD, CHESHIRE, CT 06410-3660
(860) 878-0137
Mailing address
1375 AVON BLVD, CHESHIRE, CT 06410-3660
(860) 878-0137

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
912
CT

Other

Enumeration date
02/11/2020
Last updated
02/11/2020
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